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Cardiovascular > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

index for preload

A

End diastolic volume (influenced by chamber compliance

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2
Q

HF with reduced ejection fraction is due to ___ dysfunction

A

systolic

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3
Q

cor pulmonale

A

right sided failure that results from primary pulmonary process

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4
Q

right sided failure is suceptible to failure with sudden _____

A

increase in afterload

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5
Q

right sided heart failure, RV has ___ compliance

A

high

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6
Q

2 mechanisms of compensation for heart failure

A

frank starling increase in VEDV

hypertorphy

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7
Q

negative consequences of renin-angiotensin activation

A

increase in afterload and fluid retention

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8
Q

sympathetic stim increases ___ to maintain organ perfusion

A

vasoconstriction

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9
Q

presentation symptoms of left sided failure

A

dyspenea

orthopnea

paroxysmal nocturnal pyspnea

fatigue

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10
Q

physical exam left sided failure

A

diaphoresis

tachy

pulmonary rales

loud P2 (s3 gallop in systolic dsfxn, s4 for diastolic)

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11
Q

presentation right sided failure

A

peripheral edma

right upper quadrant discomfort (liver enlargement)

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12
Q

physical exam right sided failure

A

jugular venous distention

hepatomegaly

peripheral edema

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13
Q

Digoxin therapuetic effects

A

positive ionotrope

increases vagal tone to slow HR

arterial and venous dilation

normalized baroreceptors

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14
Q

mechanism digoxin

A

inhibition of NaK ATPase - results in less drive to push Na out of Cell

results in increased levels of Ca in cells > contractility

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15
Q

ECG finding of Digoxin use

A

increased PR interval (decreasted conduction velocity in AV node, reduced firing of SA node)

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16
Q

pharmacokinetic digoxin

A

36 hour half life

oral

kidney excretion

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17
Q

adverse effects Digoxin

A

GI,

Visual disturbances

Neuro - disorientation, hallucinations

Muscular weakness and fatigue

cardiac arrhythmias

hypokalemia

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18
Q

indications DIgoxin

A

not first line

LV systolic dsfxn with AFib,

refactory pts in sinus rhythm

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19
Q

indications B adrenergic agonists (dopamine dobutamine)

A

IV hemodynamic support for acutely ill (acute decompensated HF)

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20
Q

indications phosphodiesterase inhibitors (milrinone)

A

limit IV for acute (decompensated HF)

positive inotrope and vasodilator

21
Q

therapuetic effects diuretics

A

reduce fluid volume > preload

reduced heart size

reduced edema

22
Q

loop diuretic, promotes K loss > hypokalemia

A

furosemide

23
Q

thiazide diuretic, in combo with loop diuertics, promotes k loss (hypokalemia)

A

clorothiazide

24
Q

weak diuretic activity, limited K and Mg wasting.

K sparing

A

amiloride, triamterene

25
Q

atrial dilator

A

hydralazine

26
Q

arterial vasodilator hydralazien therapuetic effect

A

reduced systemic resistance > increased stroke volume

27
Q

___ stimulates fibrosis in heart and vasculature,

cardiac hypertrophy

A

aldosterone

28
Q

promotes sympathetic activation by increasing adreal medullary catecholamien release

A

angiotensin

29
Q

promotes myocardial hypertrophy and apoptosis

A

angiotensin

30
Q

ace inhibitors

A

Captopil

lisinopril

enalapril

31
Q

actions in heart failure, ACE inhibitors

A

Decrease systemic vascular resistenace (afterload)

reduce preload

reduce Na retention, cardiac fibrosis, hypertrohpy

32
Q

ACE Inhibitors may decrease ___ function, particularly in HF patients

A

renal function

33
Q

with ACE inhibitors, ___ may develop, esp if used with aldosterone angtonist

A

hyperkalemia

34
Q

angiotensin R1 blocker

A

Losarton

35
Q

indications, losartan

A

alternative to ACE inhibitors

(avoids problematic side effects by not impacting bradykinin)

36
Q

ACE inhibitor Adverse effects

A

Hyperkalemia

angioedema

hypotension

dry cough

37
Q

angioedema, dry cough, and other side effects of ACE inhibitors due to

A

reduction of bradykinin breakdown

38
Q

veno dilator and arterial dilator combination

A

isosorbide dinatrate and hydralzine

39
Q

aldosterone antagonists

A

spironolactone, eplerenone

40
Q

therapeutic effects spironolactone, eplerenone

A

reduced edema (renal effects)

decrease fibrosis in myocardium and vessels_

41
Q

therapeutic effects Beta blockers

A

decrease arrythmias

decrease O demand,

decrease BP

prevent disease progression

42
Q

proven effective B blockers

A

carvedilol, metoprolol, bisoprolol

43
Q

Furosemide

Improve symptoms?

Decrease mortality?

Prevent CHF?

Neurohormonal Control?

A

yes

?

?

?

44
Q

digoxin

Improve symptoms?

Decrease mortality?

Prevent CHF?

Neurohormonal Control?

A

yes

no

minimal

yes

45
Q

inotropes

Improve symptoms?

Decrease mortality?

Prevent CHF?

Neurohormonal Control?

A

yes

increase mortality

?

no

46
Q

beta blockers

Improve symptoms?

Decrease mortality?

Prevent CHF?

Neurohormonal Control?

A

yes

yes

yes

yes

47
Q

ACE inhibitors

Improve symptoms?

Decrease mortality?

Prevent CHF?

Neurohormonal Control?

A

yes

yes

yes

yes

48
Q

spironolactone

Improve symptoms?

Decrease mortality?

Prevent CHF?

Neurohormonal Control?

A

yes

yes

yes

yes

Cardiovascular (39 decks)

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