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SS- Cardio > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

left heart failure: signs and Sx

A

signs: bibasilar pulmonary crackles, tachycardia (due to SNS and Epi/NE from adrenal), S3, pedal, ankle or leg edema
Sx: dyspnea on exertion progressing to dyspnea at rest, orthopnea, PND (paroxysmal nocturnal dyspnea), fatigue

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2
Q

right heart failure: signs and Sx

A

signs: pedal, ankle or leg edema (buildup of venous back pressure), jugular venous distension, hepatomegaly, ascites
Sx: edema of feet, then ankles, then legs, abdominal distention

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3
Q

normal LVEDP/LVEDV/SV/EF/LVESV

A

10/150/100/67/50

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4
Q

failing heart

LVEDP/LVEDV/SV/EF/LVESV

A

40/300/50/17/250

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5
Q

At what % reduction of FSV do patients begin to have symptoms?

A

25%

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6
Q

How do left HF patients develop edema?

A

ventricular dilation and myocardial hypertrophy -> decreased CO -> decreased renal perfusion -> increased Na retention -> increased osmotic pressure -> increased ADH -> increased water reabsorption -> edema

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7
Q

Differentiate among pulmonary edema due to Left HF, septic shock, and hemorrhagic shock

A

pulmonary capillary pressure
left HF: high
septic shock: normal
hemorragic shock: low

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8
Q

systolic HF

A

elderly
HF with dyspnea, orthopnea, PND, bibasilar pulmonary crackles
NORMAL EF

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9
Q

normal HF

A

long standing HTN, obese, concentric left ventricular hypertrophy

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10
Q

diastolic HF

A

noncompliant left ventricle with impaired diastolic function and filling
preserved EF

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11
Q

B-type natriuretic peptide

A

elevated in HF

function: counter-regulatory; vasodilation and increased sodium excretion

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12
Q

causes of right heart failure

A 
most common: left heart failure
cor pulmonale (most are compensated so don't have RHF)
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13
Q

syndrome of inappropriate antidiuretic hormone (SIADH)

A

25% of acute heart failure

retain lots of water: systolic left HF

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14
Q

peripartum cardiomyopathy (PPCM)

A

heart failure in previously healthy woman

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15
Q

HF proinflammatory cytokines

A

TNF, IL-1, IL-6

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16
Q

hemodynamic classifications of HF

A
  1. warm and dry (goal)
  2. cold and dry (inadequate perfusion; need vasodilator)
  3. warm and wet (congestion; need diuretics)
  4. cold and wet (congestion and inadequate perfusion; need vasodilators and diuretics)
17
Q

distributive shock

A 
diffuse vasodilation
warm and dry
decrease: preload and after load (primary)
increase: CO
sepsis, anaphylaxis, TSS
18
Q

obstructive shock

A 
obstruction
cold and clammy 
increase: preload and after load 
decrease: CO (primary)
cardiac tamponade and pulmonary embolism
19
Q

cardiogenic shock

A 
ventricular failure
cold and clammy
increase: preload and after load
decrease: CO (primary)
acute MI, HF, valvular dysfunction, arrhythmia
20
Q

hypovolemic shock

A 
loss of blood
cold and clammy
decrease: preload (primary) and CO
increase: after load 
hemorrhage, dehydration, burns
21
Q

signs of shock

A

elevated serum lactate
hypotension (remember to adjust for people with HTN)
behavior: disorientation, confusion, obtundation
skin: mottled, cold, clammy, pale or cyanotic
urine: decreased output

22
Q

compensated aortic regurgitation LVEDP/LVEDV/SV/EF/LVESV

A

12/250/200/80/50

23
Q

decompensated aortic regurgitation (HF): LVEDP/LVEDV/SV/EF/LVESV

A

40/300/150/50/150

24
Q

How should you treat a patient with severe acute uncompensated aortic regurgitation?

A

SURGICAL EMERGENCY

25
Q

normal LAP/LVEDV/RSV/FSV/EF/LVESV

A

10/150/0/100/67/50

26
Q

acute mitral regurgitation LAP/LVEDV/RSV/FSV/EF/LVESV

A

25/170/65/65/76/40

27
Q

compensated mitral regurgitation LAP/LVEDV/RSV/FSV/EF/LVESV

A

15/250/100/100/80/50

28
Q

chronic mitral regurgitation LAP/LVEDV/RSV/FSV/EF/LVESV

A

25/280/80/80/55/120

29
Q

severe blood loss

LVEDP/LVEDV/SV/EF/LVESV

A

2/100/75/75/25

30
Q

compensated HF LVEDP/LVEDV/SV/EF/LVESV

A

12/200/100/50/100

31
Q

dilated ventricle LVEDP/LVEDV/SV/EF/LVESV

A

40/250/65/26/185

32
Q

class I HF

A

asymptomatic

33
Q

class II HF

A

have to stop normal daily activities to rest

34
Q

class III HF

A

only make it a couple of steps before out of breath

35
Q

class IV HF

A

can’t get out of bed

36
Q

What can EF not predict?

A

CO, renal blood flow, RAA activation, salt/H20 retention

37
Q

effect of bed rest on CHF with dilated myopathy

A

1st: signs and symptoms disappear
2nd: increased response to medical management
3rd: cardiomegaly recedes

38
Q

stiff non-compliant ventricle

LVEDP/LVEDV/SV/EF/LVESV

A

40/100/65/65/35

SS- Cardio (16 decks)

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