Heart Failure Flashcards
In terms of volume, central venous pressure increases with ____ and decreases with _____.
volume overload
volume depletion
What is the range of normal central venous pressure?
about 2 mm Hg to about 8 mm Hg
You can think of 6 mm Hg as an average normal CVP
How do you measure CVP?
from the tip of a central venous catheter in the superior vena cava.
How to you test to see if a patient in heart failure is volume depleted?
Give the patient a bolus of fluid via the central line. If the CVP goes up and
stays up, volume depletion is not the problem. If CVP goes up transiently and then falls back down, the patient may have both heart failure and volume depletion.
What is the equation for left ventricular end systolic volume?
LVESV = LVEDV – SV
What is normal left ventricular end diastolic pressure ?
4 mm Hg to about 12 mm Hg.
10 mm Hg as an average normal LVEDP
What is the normal LVEDV?
65 ml to around 240 ml.
120 ml as an average normal LVEDV
What is a normal stroke volume?
55 ml to about 100 ml.
70 ml as an average normal SV
What is a normal ejection fraction?
50% to about 75%
60% as an average normal EF
What is normal LVESV?
15 ml to about 145 ml
50 ml as average normal LVESV
Does a failing heart have higher or lower LVEDP than normal?
higher (4X)
Does a failing heart have higher or lower LVEDV than normal?
higher (2X)
Does a failing heart have higher or lower SV than normal?
lower (2X)
Does a failing heart have higher or lower EF than normal?
lower (50% points)
Does a failing heart have higher or lower LVESV than normal?
higher (5X)
When and what is the initial symptom of heart failure?
exertional dyspnea
True or false: most heart failure patients have isolated left failure.
FALSE: Most heart failure patients have both left and right heart failure.
What is the level of stroke volume reduction that stands as the threshold for heart failure? Why is it set at this number?
25% reduction in stroke volume is when patients begin to have symptoms
Is mitral valve regurgitation a cause or effect of heart failure?
BOTH- it can be either
Mitral regurgitation causes a heart murmur when?
systole (blowing holosytolic murmur)
MItral stenosis causes a heart murmur when?
diastole
Aortic regurgitation causes a heart murmur when?
diastole
Aortic stenosis causes a heart murmur when?
systole
List the top 4 left heart failure symptoms.
1) Dyspnea on exertion progressing to dyspnea at rest
2) Orthopnea
3) PND (paroxysmal nocturnal dyspnea)
4) Fatigue