Heart Failure Flashcards
HEART FAILURE: PART 1
HEART FAILURE: PART 1
The heart generates almost all of its energy needed to drive its primary function (pumping blood) through ________ metabolism (O2 requiring processes).
aerobic
Where is O2 consumed?
mitochondria
Is there energy storage within the heart?
No, the heart matches its energy needs for contractile activity with energy synthesis in real time.
An ________ to match energy synthesis (O2) with energy expenditure (contractility) compromises cardiac function.
inability
We can link the ___ supply chain to the cardinal signs and symptoms of cardiac dysfunction, what are these S/S?
O2
- Inappropriate fatigue/weakness
- dyspnea (SOB)
- Exercise intolerance (6MWT)
- Rapid or irregular heart beat
- Bilateral LE swelling
- Persistent cough
- Cardiac output is a measure of ______ __________.
- CO = __ * __
- Resting CO = _______
- Resting SV = ________
- Resting HR = ________
- cardiac function
- SV*HR
- 4.5-5.0 L/min
- 60-70 mls
- 70 bpm
What 3 important factors is SV dependant on?
- preload
- afterload
- contractility
What is ejection fraction?
EF = (EDV-ESV)/EDV*100
-Ejection fraction is the amount of blood from the left ventricle that is ejected % wise.
- What is a normal EF range?
- EF can remain ________ despite a change in EDV or ESV.
- 60-75%
- unchanged
- Does the heart have its own circulatory system?
- Blood flows through these vessels only during cardiac __________.
- Yes, coronary arteries
- systole
Coronary blood flow is regulated by what 4 things?
- coronary artery pressure
- local metabolic signals
- signals from the endothelium
- neural and hormonal molecules
What is the most important determinant of CO?
radius of vessel
Look at Wiggers Diagram
Look at Wiggers Diagram
What is heart failure?
“The situation where the heart is incapable of maintaining a cardiac output adequate to accommodate metabolic needs and venous return”
Heart failure (HF) is a complex clinical syndrome that results from any __________ or __________ impairment of ventricular ______ or _______ of blood.
- structural or functional
- filling or ejection
Is heart failure a reason to not treat a patient?
No
Causes of Heart Failure (HF):
- _______ ________ Disease (CAD; 2/3’s of all cases)/ischemic heart disease (IHD)
- Uncontrolled ____(pulmonary or systemic)
- Valvular disease
- Uncontrolled ________
- Long standing _______ abuse
- Hx of __’s
- Age
- Age associated increased ventricular stiffness (loss of compliance)
- Coronary Artery Disease
- HTN
- diabetes
- ETOH
- MI
CAD is responsible for about / of all heart failure cases.
2/3
HEART FAILURE: PART 2
HEART FAILURE: PART 2
Heart Failure (HF) Common Clinical Signs:
- Fluid ________
- Ascites: Fluid retention in the _______
- Pleural effusions (fluid between the ______ pleura)
- _________ ________ distension(JVD)
- _____________ (enlargement of liver)
- Pitting edema
- _______cardia
- S3gallop
- retention
- abdomen
- lung
- Jugular Venous Distension (JVD)
- hepatomegaly
- tachycardia
Can heart failure be L or R sided?
Yes, it can be both
HFpEF vs HFrEF
HFpEF = Heart Failure w/ preserved ejection fraction
HFrEF = Heart Failure w/ reduced ejection fraction
Patients with left sided HF have compromised __________. What is the impact of this?
Contractility
- reduced SV, EF, and CO
- blood flow to the body is reduced
- fatigue, exercise intolerance, SOB
What are some causes of left sided HF?
- HTN
- CAD (Coronary Artery Disease)
- Arrhythmias
- Decreased CO caused by impaired ventricular filling and decreased ventricular relaxation