Heart Failure Flashcards
Left sided heart failure occurs with
- Left ventricular insult
- Reduces CO leading to accumulation of fluid in L atrium, pulmonary congestion & pulmonary edema
- Augmented by renal mediated fluid retention
Right sided HF occurs following
- Insult of right ventricle
- Commonly caused by elevated pressures in pulmonary arterial system
- Reduces R ventricular CO resulting in venous congestion leading to jugular venous distention & peripheral edema as well as ascites and pleural effusion
Pulmonary edema produces the 2 hallmark pulmonary signs of L sided HF
- Dyspnea
- Cough
Pts experiencing an acute exacerbation of HF typically present in _______________ HF where L sided HF results in pulmonary vascular congestion, R ventricular overload, & ultimately systemic vascular congestion
- Biventricular HF
________________ HF may be due to either systolic or diastolic dysfunction of the L ventricle & also referred as HF with _________ or __________ ejection fraction
- Functional
- Reduced or Preserved
Describe systolic dysfunction HF
- HF w/reduced ejection fraction
- Compromised contractile function of ventricles reducing stroke volume, CO< and ejection fraction
- L ventricular ejection fraction <40%
- Weakened heart msucle
Describe diastolic dysfunction HF
- HF w/preserved ejection fraction
- Ventricles cannot fill adequately during relaxation
- L ventricular ejection fraction remains unaltered or remains b/w 55-75%
- Stiffened heart muscle
HF with reduced ejection fraction leads to ___________ Renin Angiotensin Aldosterone System Activity
- Increased
Describe cardiorenal syndrome
- Ischemia, cardiomyopathy, or arrhythmia leads to acute cardiac insult
- Decreased CO and perfusion
- Increased venous pressure leading to acute kidney injury
Diagnosis of HF
- ECG
- Pro-BNP >125
- BNP ≥35
- Transthoracic echocardiography
AHA stages of HF
- Stage A: high risk for developing HF
- Stage B: structural heart disease strongly associated w/development of HF but no s/s of HF
- Stage C: Symptomatic HF w/associated underlying structural heart disease
- Stage D: Advanced structural disease w/marked symptomology at rest despite maximal medical therapy
NYHA classification of HF
- Stage I: No limitation in activity
- Stage II: Slight limitation in activity, comfortable at rest
- Stage III: Marked limitation of activity, sx w/less than ordinary activity
- Stage IV: Sx at rest, unable to do any physical activity w/o symptomology
CPG for HF (more specific to HFrEF)
- Advocate for increased total daily physical activity
- Educate & facilitate chronic disease management behaviors
- Prescribe aerobic exercise training in stable HF
- Prescribe HIIT
- Prescribe resistance training
- Prescribe combined aerobic and resistance training
- Prescribe inspiratory muscle training
- Prescribe combined inspiratory muscle training & aerobic exercise training
- Prescribe neuromuscular electrical stimulation (NMES)
Green zone for CHF (congestive heart failure) NO
- SOB
- Swelling
- Weight gain
- Chest pain
- Decrease in your ability to maintain your activity level
Yellow zone for CHF (may indicate need for medication adjustment)
- Weight gain of ≥3 lbs in 2 days
- Increased coughing
- Increased swelling
- Increase in SOB with activity
- Increase in number of pillows needed
- Anything else unusual that bothers you
