heart failure Flashcards
What is the #1 reason for hospitalization of patients age 65 and older?
heart failure
What is the definition of heart failure?
Inability of the heart to pump sufficient blood to meet the needs of the tissues for oxygen and nutrients
what controls heart rate
Autonomic nervous system (sympathetic and parasympathetic)
What are the components of stroke volume?
Preload, afterload, contractility
what is preload
Amount of blood in the ventricle at the end of diastole → venous return of blood, compliance of ventricular
what is afterload
Amount of resistance to the ejection of blood
what is contractility
Percentage of blood volume in the ventricles at the end of diastole that is ejected during systole
what is systolic heart failure
Impaired contraction of the heart, low EF, left-sided systolic heart failure
what is diastolic heart failure
Impaired filling of the heart stiffened and noncompliant heart muscle, normal EF
which heart failure is more common (systolic or diastolic)
systolic
what does BNP indicate
how much the chambers stetch
what is the most accurate method of identifying chronic heart failure
BNP
what does BNP do
reduces systemic blood pressure by reducing afterload
what is ventricular remodeling
Heart compensates for the increased workload to increase the thickness of the heart muscle (ventricular hypertrophy)
Enlarged myocardial cells become dysfunctional and die early → leaving the other normal myocardial cells struggling to maintain CO
what are the symptoms of left sided heart failure
lung symptoms
what are the symptoms of right sided heart failure
the rest of the body
what is the ending for ACE inhibitors
Pril
what do ACE inhibitors do?
Relieve the s/s of HF and significantly decrease mortality and morbidity of HF
What are the side effects of ACE inhibitors?
Angioedema (rare allergic reaction), dry cough, and hyperkalemia
What is the ending for ARBs?
Sartan
why would an ARB be prescribed
Patient couldn’t tolerate ACE inhibitors
what are the side effects of ARBs
Hyperkalemia, hypotension, and renal dysfunction
why would a nitrate be prescribed
Patient couldn’t tolerate ACE inhibitors
what does nitrate do
venous dilation lowers preload
what does hydralazine do
lowers systemic vascular resistance and left ventricular afterload
what heart failure medication should be prescribed to a patient with poor kidney function
hydralazine
what is the ending for beta blockers
olol
what does a beta blocker do
reduces the sympathetic nerve stimlation (lowers HR)
what are the side effects of beta blockers
Tired and inability to get it up
Patient may feel worse at the beginning
how should furosemide be given and why
Very slow push, worried about ototoxicity
what diuretic is potassium sparing
spironolactone
what are the side effects of diuretics
Electrolyte imbalances, symptomatic hypotension, hyperuricemia (gout), and cardiorenal syndrome
what is cardiorenal syndrome
resistance to diuretics
what is the most common digitalis
digoxin
what is the first sign of digoxin toxicity
vision changes
what are the signs of digoxin toxicity
Vision changes, anorexia, nausea, vomiting, fatigue, depression, malaise, changes in heart rate or rhythm; onset of irregular rhythm, sagging ST
what should be monitored alongside digoxin and why
Serum potassium, hypokalemia enhances digoxin and could lead to toxicity
What is a positive inotrope?
amiodarone
what are the benefits of amiodarone
Improved cardiac output, stroke volume
what is the risk of amiodarone
Increased myocardial oxygen consumption
