Heart Failure Flashcards
heart failure
inadequate pumping/filling of the heart
risk factors
hypertension and CAD
sympathetic Nervous System
release epi/nor epi to increase HR, increase Myocardial contractility
neurohormonal compensatory mechanism
kidneys release renin–> angiotensin I–> angitotensis II by vonverting enzyme in lungs.
neurohormonal compensatory mechanism
kidneys release renin–> angiotensin I–> angitotensis II by vonverting enzyme in lungs.
ventricular dilation
CO decreases, elastic elements of muscle fibers are overstretched and can no longer contract effectively
hypertrophy
increase in muscle mass in cardiac wall
hypertrophy
increase in muscle mass in cardiac wall
counterregulatory hormones
released in response to increased artial volume and ventricular pressure
left sided heart failure
most common, prevents normal forward blood flow and causes blood to back up into L atrium and pulmonary veins
S/S of L sided heart failure
pulmonary congestion and edema
right sided heart failure
right ventricle fails to contract effectively causes blood back up in R atrium and venous circulation
S/S of R sided heart failure
Jugular vein distention, hepato/splenomegaly, peri edema
clinical manifestations of HF
fatigue, dyspnea, orthopnea, persistent dry cough, tachycardia, dependent edema. >3lb weight gain in 2 days –> contact physician if these occur
complications of HF
pleural effusion, dystrhythmias, LV thrombus, hepatomegaly, renal failure
pleural effusion
increased pressure in the pleural capillaries
dysrthymias
numerous sites fire rapidly and spontaneously
LV thrombus
LV contractility, decreased CO, risk for stroke
LV thrombus
LV contractility, decreased CO, risk for stroke
hepatomegaly
liver becomes congested w/ venous blood, leading to impaired liver function
renal failure
decreased CO results in decreased perfusion to kidneys
Diagnostic Studies
history, physical exams, underlying cause, chest XR, 12-lead ECG, hemodynamic monitory, 2 dimensional echocardiogram, cardiac cath
Diuretics
mainstay of treatment in patients w/ volume overload. Decrease Na reabsorption at various sites w/in the nephrons, and thereby enhancing Na +H2O loss.
vasodilators
IV nitroglycerin is a V.D that reduces circulating blood volume
morphine
reduces preload and afterload, dialtes pulmonary and systemic blood vessels
positive inotropes
increase myocardial contractility
ACE inhibitors
primary drug choice for blocking RAAS
B-Aderenergic Blockers
directly block the negative effects of the SNS
nitrates
cause vasodilation by acting directly on the smooth muscle of vessel wall/coronary artieries
S/S of L sided heart failure
pulmonary congestion and edema, crackles, increased HR, pleural effusion, S3 S4 sounds , fatigue, dyspnea, shallow resp. orthopnea, frothy pink sputum
S/S of R sided heart failure
Jugular vein distention, hepato/splenomegaly, peri edema, murmurs, weight gain, increased HR, fatigue, anorexia + GI bloating
