heart failure Flashcards
types of HF
left sided/right sided
systolic or diastolic
acute or chronic
most common type of HF
left sided
what happens in left sided HF
blood backs up in lungs
- systolic, diastolic, or mixed s/d failure
- pulmonary edema
systolic HF occurs bc of…
inability of the heart to pump d/t…
- decreased contractility
- increased after load (HTN)
- cardiomyopathy
what does systolic HF result in
less than 45% EF
can get as low as 5-10% (not good life expectancy)
diastolic HF occurs because of…
inability of ventricles to relax and fill with blood
most common cause of diastolic HF
HTN -> left ventricular hypertrophy
what is mixed systolic and diastolic HF
extremely low EF with high pulmonary pressures
- biventricular failure
- typically d/t dilated cardiomyopathy
what is increased in pulmonary edema
-pulmonary/cap. hydrostatic pressure
- lymphatic flow
- fluid in alveoli
right sided HF results in
blood backing up into veins
right sided hf etiology
left hf
rv infarction
cor pulmonale
types of right sided HF
acute- decompensated
chronic- biventricular
stage 1 NYHA HF
no limitations, no S&S with nl activity
stage 2 NYHA HF
slight limitations, S&S with nl activity
stage 3 NYHA HF
marked limitations, comfortable at rest
stage 4 NYHA HF
cannot carry on activity, S&S at rest, hospitalized
3 compensatory mechanisms in HF
RAAS
SNS
natriuretic peptides
what triggers RAAS compensatory mechanism in HF and what does it result in
- low CO and decreased renal perfusion
- vasoconstriction, fluid retention, increased BP
SNS compensatory mechanism trigger
low SV and CO
SNS compensation results in…
vasoconstriction
+inotropy
+ chronotropy
increased preload/afterload
dilation-> hypertrophy
renal effects of ANP and BNP
diuresis and natriuresis
(more pee and sodium in pee)
CV effects of ANP and BNP
vasodilation
hormonal effects of ANP and BNP
inhibit RAAS
prevents ADH release
S&S of leftsided HF
- crackles, dyspnea, orthopnea, cough
- S3, S4, pulses alternans, tachycardia
- AMS, confusion, kidney issues
S&S of rightsided HF
- edema
- JVD, hepatomegaly (RUQ pain)
- wt gain (3lbs in 2 days = ADHF)
S&S of chronic HF
FACES
fatigue
activity limitation
congestion/cough
edema
SOB
S&S of ADHF
SCARS
skin pale clammy and cyanotic
crackles
AMS
respirations tachy and labored
sputum pink and frothy
3 ways to diagnose HF
echo (to get EF)
EKG
MUGA scan
BNP labs indicating severity of HF
> 100= HF
300= mild HF
600= moderate HF
900= severe HF
tx / interventions for acute HF
oxygen
fluid restriction
telemetry
daily weights
best way to track fluid balance day by day
daily weights
first line meds for drug therapy
RAAS inhibitors (ACE-I and ARBs)
other drug tx for HF
diuretics
BB
vasodilators
inotropes
antidysrhythmics
morphine for vasodilation
ideal med for BP and pain
morphine
what does AICD stand for
automatic implantable cardioverter defibrillator
teaching for AICD
- cannot raise arm over shoulder lvl
- avoid magnets
- dont carry cell in pocket
- keep devise info card on person
VAD stands for
ventricular assisted advice
