Heart Failure and Circulatory Shock Flashcards
What are natriuretic peptides?
Healthy, stretch induced peptides that promote sodium and potassium excretion, inhibit renin and block angiotensin 2 activity, and inhibit norepinephrine secretion.
What are the three compensatory mechanisms for heart failure that we discussed?
- Myocardial hypertrophy
- Sympathetic reflexes
- Renin-angiotensin-aldosterone system
How does myocardial hypertrophy act as a compensatory mechanism for heart failure?
?
How do sympathetic reflexes act as compensatory mechanisms for heart failure?
?
How does the renin-angiotensin-aldosterone system act as a compensatory mechanism for heart failure?
Kidneys increase blood pressure and blood volume in an attempt to increase preloading.
What is the end stage of most heart pathologies?
Heart failure
Describe symmetrical myocardial hypertrophy
“Athlete’s Heart”. Myocardial wall hypertrophies and ventricle grows proportionally.
Describe concentric myocardial hypertrophy
Wall thickens at the expense of ventricular volume.
Describe eccentric myocardial hypertrophy
Wall thins, and the volume of the ventricle grows in an attempt to increase preload.
T/F: Lower ejection fraction increases the risk for sudden cardiac death and 5 year mortality rate.
TRUE.
T/F: Congestive heart failure is synonymous with left ventricular dysfunction.
FALSE. You can have LVD without congestion.
What are some symptoms of left sided heart failure?
- Exertion dyspnea,
- Orthopnea (difficulty breathing laying flat, measured in pillows)
- Paroxysmal nocturnal dyspnea
- Cyanosis (blueish discoloration)
- -Elevation of pressure in pulmonary circulation.
What is paroxysmal nocturnal dyspnea?
Sudden nighttime difficulty breathing brought on by increased veinous return to heart during laying down causing increased preload and O2 demand of the heart.
What are some symptoms of right sided heart failure?
- Fatigue
- Dependent edema
- Distention of jugular veins
- Liver engorgement
- Ascites
- Anorexia and GI distress
- Cyanosis
- Elevated peripheral pressure.
What is right sided heart failure?
Fluid buildup in right atrium, goes into systemic circulation causing dependent edema.
What is cor pulmonale
-enlargement of the right side of the heart as a result of lung dysfunction.
What are the most common drug treatments of CHF?
Diuretics, ACE inhibitors/ARBs, Beta blockers.
How does an Intra-aortic balloon pump work?
???Inflates with diastole, deflates in systole. Increases aortic pressure during diastole which increases blood flow. Decreases BP during systole, eases blood flow out of heart.
T/F: IABP’s are permanent.
FALSE
T/F: LVAD’s are permanent.
TRUE, they can be.
Which is smaller, an impella or an LVAD?
Impella, but it’s temporary.
What symptoms do R and L sided heart failure share?
- Cyanosis
- Pulmonary symptoms
- Fluid retention and edema
- Altered physical activity tolerance
- General muscle wasting
- Malnutrition
What are the four types of circulatory shock?
- Cardiogenic: ventricles not functioning properly. Decreased ventricular function, decreased cardiac output, hypoxia.
- Hypovolemic: low blood volume, decreased BP, decreased O2 delivery ability.
- Obstructive: Blood flow restricted by great vessels in heart, decreased loading/output, decreased O2 carrying capacity.
- Vasodilatory: decreased BP, no pressure gradients. Poor preload and
