Heart Failure and Circulatory Shock Flashcards
heart failure
heart has an issue with pumping effectively
can’t meet the body’s needs in the moment
compensatory mechanisms
only temporary
interconnected
work harder in an injured heart
makes matters worse if they last too long
natriuretic peptides
gradual change of cardiac and fibrous tissue
changes the property of the heart chambers
due to an increase in muscle, it requires more oxygen, but a thicker wall decreases wall stress
Frank-Starling
the more work you do, the more work you get
only works to a point
increased EDV
Renin-angiotensin-aldosterone mechanism
secreted when kidneys aren’t getting enough blood flow
retains water, therefore increasing vascular volume
sympathetic reflexes
HF elicits a high working SNS, which creates a high HR and increased contractility
vascular tone
helps increase perfusion pressure
gives a person a BP
symmetrical hypertrophy
chamber size and wall thickness increase at a proportional rate
commonly seen in aerobic athletes
concentric hypertrophy
caused by aortic stenosis and HTN
wall thickness is much greater than the chamber size
decrease in stroke volume
eccentric hypertrophy
thin wall and big chamber
aortic regurgitation
increase in wall stress
high output classification
heart can’t meet the demands of the body
anemia is a cause
low output classification
common classification
decreases in CO
LVD
right-sided classification
blood backs up in the RA and goes back out into the systemic circulation
most common classification
low output, systolic, left-sided heart failure
ejection fraction
amount of blood ejected during a contraction
55-65% is normal
50-55% is mild
30-50% is moderate, increase in 5 year mortality
left-sided HF symptoms
dyspnea orthopnea LVD cyanosis paroxysmal nocturnal dyspnea blood tinged sputum elevation in pulmonary capillary wedge pressure
right-sided HF symptoms
dependent edema cyanosis distention of jugular veins ascites GI complaints anorexia elevated peripheral venous pressure fatigue
common signs and symptoms of HF
cyanosis muscle wasting (cachexia) malnutrition fluid retention SOB with exertion and other pulmonary symptoms altered/limited exercise tolerance
diuretics
decreases the vascular volume, therefore decreasing congestion
allows for changes in dosage with regards to body weight
Lasix (loop)
can decrease BP
digoxin
taken orally
increases contractility, making the heart pump more effectively
shuts down Na-K+ ATPase
diminishes symptoms with SOB
beta blockers
decreases SNS input
ACE inhibitors
prevents the production of these hormones and therefore decreases the amount of fluid in circulation
aortic balloon pump
inflates with diastole and deflates with systole increases aortic arch pressure decreases demand very temporary (days-1 week max) stay in bed used after CABG or acute MI
LVAD
pulls blood out of LV and goes to aorta
wire comes out of body and connects to battery pack
can go home with this
used to be a bridge therapy before transplant
