Heart Failure And Endocartitis Flashcards
Heart failure definition
Inability of the heart to provide sufficient forward output to meet the perfusion and oxygenation requirements of the tissues while maintaining normal filling pressures
Systolic dysfunction ( HFrEF)
More common
<45
Impaired cardiac contractile = decreased CO
Relaxes but cant contract
LVH = Pulmonary edema
PE: S3 gallop , rales in lungs, displaced PMI, peripheral edema
Diastolic HFpEF
Abnormal cardiac relaxation , stiffness or filling resulting in fluid overload
“ contracts but wont relax”
The LV muscle has lost ability to fill properly.
Heart muscle grows inward = Concentric Hypertrophy
> 50 % EF
PE; s4 Gallop , normal PMI, rales and crackles,
Left sided HF symptoms
PULMONARY symptoms
- dyspnea
- othropnea
- paroxysmal nocturnal dyspnea
- pulmonary edema in severe
Left sided Signs
Bilateral basilar rales Cardiac asthma S3/S4 Pulses anternans Lateral displaced apical pulse Cold extremities
Right sided Symptoms
Dominant venous congestion symptoms
Lower leg edem
Abdominal distension
Jaundice
N/ loss of appetite
Right sided signs
Bilateral pitting ede, Increased CVD - JVD - hepatomegaly - ascites
Ejection fraction
Stroke volume / end diastolic volume
Normal 55-70 %
Prevention of HF exacerbations
Sodium restriction Fluid restriction < 2L Medication adherence End of life discussions Management of co-morbidities
Beta blockers
Lessen symptoms and reduce preload and afterload
ACEI
Prevents further HF, alleviate symptoms and improve survival
NYHA classifications I
No symptoms, normal PE
NYHA classifications II
Symptoms present only during increased physical activity, comfortable at rest
NYHA classifications III
Symptoms appear during light PE , comfortable ONLY at rest
NYHA classifications IV
Severe limitation , symptoms even a rest
