Heart Failure Flashcards
how come heart failure patients might die
ventricular arrythmia or a fib
twin epidemics due to rising of both issues
heart failure and a fib
decrease output causes decrease EJ which leads to
decrease blood flow to organs
things that affect preload
volume
things that affect afterload
blood pressure/vasoconstricition
what dose increase afterload do to the heart
increase in muscle size because heart has to work harder
if EF is low what does that do to the volume
increase ECF
if EF is low and there is not a lot of perfusion to kidneys what happens
increase in renin and angiotensin and then an increase in salt and water which leads to fluid overload
is the fluid overload in HF always in the vessels
no so it doesn’t necessarily increase preload
what type of relationship is associated with afterload and cardiac performance
inverse
names for HF with EF less than 40%
Reduced, systolic, HFrEF
names for HF with EF greater than 40%
persevered, diastolic, HFpEF
left sided HF will have what symptoms
LUNGS
- crackles
what symptoms with right sided HF have
peripheral edema
REST OF BODY
causes of depressed ejection fraction
myocardial infarction
hypertension
volume overload
causes of preserved EF
pathology hypertropy
aging
decreased CO will lead to what in the vessels
vasoconstriction (ultimately leading to increase afterload)
what effect will angiotensin 2 have on preload and aferload
increase in both
RAAS happens becasue
the body is attempting to compensate
what gender experiences what type of HF
men is reduced
women is preserved
blood pressure in reduced
normal to low
blood pressure in preserved
hypertension
edema in reduced
pitting
edema in preserved
no edema
EJ in reduced
low
EJ in preserved
normal or increased
JVD in reduced
yes
JVD in preserved
no
symptoms of HF
exertion dyspnea
orthopena
nocturne
fatigue
anorexia
N/V
cheyne stokes
decrease urine
cool and cyanotic
if output is not enough what will the body do to compensate
increase HR
(leads to larger heart)
S/S of pulmonary edema
air hunger
crackles
frothy sputum (pink)
ashen color of skin
BNP normal
less than 100
what can impact BNP
meds
why do we do an echo
check EF
why do we do a CXR
size and shape of the heart
Class 1 heart failure
no limitation
class 2 HF
symptoms with ordinary activity
class 3 HF
symptoms with less than ordinary activity
class 4 HF
symptoms of cardiac insuffiencieny at rest
what meds decrease preload
diuretics
what can decrease afterload
bb
what is the best combo of meds
bb and acei
SIDE EFFECTS OF ACEI
angioedema
neurohormonal escape in acei
in reduced
circulating levels of angiotensin 2 return to pretreatment level with long term acei therapy
big thing to watch for with dig
toxicity
what electrolyte do we watch for with dig
k
micronutrient to increase
thiamine
cardiac resynchronization therapy
pacemaker life and prevents going into ventricular arrhythmia
- special because lead into left ventricular
significant 6
- education of partner and patient
smoking cessation
weight monitoring
symptoms to report
diet
activity
medicaitons
best indicator of fluid status
weight
broken heart syndom
extreme metal stress
- women more than men
dilated cardiomyopathy
dilation of both ventricles without muscle hypertrophy
extrinsic cause of cardiomypopathy
know the cause
- hytpertension
intrinsic cause of cardiomyopathy
don’t know why
bacterial endocardiatis
bacteria around the heart
bacteremia
bacteria in blood stream
modified duke criteria
defective: def has it
possible
rejected: don’t have it
S1 is produced by
mitral and tricuspid closure
S2 is proceeded by
closure of aortic and pulmonic
when does S3 occur
after S2
when does S4 occur
before S1
stenotic
murmur of blood shooting through the narrow opening when the value is open
regurgitant
murmur of blood leaking back through when the valve should be closed
- valve fails to close fully
murmur
- grade 1
audible with good stethoscope in a quite room
murmur
- grade 2
quite but readily audible with stethoscope
murmur
- grade 3
easily heard with stethoscope
murmur
- grade 4
loud and obvious murmur with palpable thrill
murmur
- grade 5
very loud, heard only over the pericardium but else where in the body
murmur
- grade 6
heard with stethoscope off chest
