Heart Failure Flashcards
Heart Failure =
Pump Failure
Heart Failure
can lead to multi organ failure due to inefficient blood flow
Causes: CAD, HTN (uncontrolled), ETOH abuse, cardiomyopathy, MI
Signs: Crackles/Rochi, activity intolerance, tachypnea, tachycardia, cough, gallop rhythms, cyanosis, pulmonary edema
Symptoms: fatigue, dyspnea, orthopnea, paroxysmal nocturnal dyspnea
* CRACKLES!! start in lower lobes and move upwards w/ worsening
Systolic HF
- Decreases contractility
- Decreased L ventricular EF%
- Starling’s Law! ( compensatory mechanisms eventually subside -> decreased CO and symptoms appear)
Diastolic HF
- Impaired relaxtion/filling
- Stiffness throughout diastolic
- Decreased filling -> Decreased SV + Decreased CO
Pulmonary Edema
fluid into alveoli (medical emergency!)
Stage I: Fluid outside alveoli
Stage II: alveolar edema from fluids into alveoli
* blood is pumping but lacking O2
* fluid must be removed for oxygenation to occur
S/S: pink frothy sputum
IV Lasix!, chest PT in Trendelenburg
Compensatory Mechanisms
Neurohormonal Systems: decreased CO -> RAAS stimulates aldosterone -> increased blood volumes
R. Heart Failure
- JVD
- Edema
- Hepatomegaly + Spleenomegaly
- GI symptoms - “fullness”
- Signs: Peripheral edema, hepatomegaly, spleenomegaly, ascites, JVD
- Symptoms: Weakness, anorexia, indigestion, wegith gain, mental changes
Diagnosis - BNP
Too much stretch, heart muscles shred off
* BNP < 100: Pulmonary cause
* BNP > 100: Dyspnea r/t heart cause
* BNP > 400: Definite HF
Diagnosis (HF)
Head to Toe
CXR
echo
Treatment (HF)
Intra Aorta Ballon Pump
* temporary
* contracts
* Decrease Ventricular Workload
ACE inhibitor + Beta Blocker
Vasotec, Lopressor
Capoten, Coreg
Monopril
Nesiritide: vasodilator, Digoxin, Diuretics !, Daily Weights, Activity w/ rest , Fluid + sodium restrictions
