Heart Failure and Valvular Diseases (5) Flashcards
CO =
HR x SV
SV =
Preload, afterload and contractility
What do ejection fraction and cardiac output attempt to measure?
Contractility - but contractility is always affected by loading conditions.
LV hypertrophy is common in people with which conditions?
Hypertension, aortic stenosis
In patients with LV hypertrophy, which is more appropriate, inotropes or volume?
VOLUME - a stiff ventricle requires higher filling pressures to function. Vasodilators are a second choice if pt is euvolemic. Inotropes are the last choice.
What are the four risk factors associated with developing ***HF?
Smoking, Obesity, Diabetes, hypertension
***For best performance, patients with systolic CHF need ____ _____ for optimal contractility.
Volume loading.
***How can one improve contractility in a patient with sCHF?
Volume loading, lower BP and CO, IABP, inotropes
An elevated BNP is a diagnostic indicator of what?
Diastolic CHF
Myocardial edema causes universal ______ _______ in the first 3 hours after surgery.
diastolic dysfunction (heart muscle can’t relax/ventricle can’t fill.)
***How can one treat the diastolic dysfunction after cardiac surgery?
Give volume (increase preload) Lower HR (increase filling time) Prolong AV delay (if pacing is required) Diuresis and volume expansion
***hypoxemia, hypercarbia, and acidosis all (Increase/Decrease) pulmonary pressures.
INCREASE - causing R heart strain.
***What is a ventilator strategy to reduce pulmonary pressures?
hyperventilate - lowering CO2 and causing alkalosis.
Cardiopulmonary bypass causes SIRS, which leads to an (increased/decreased) PVR
Cardiopulmonary bypass causes SIRS, which leads to an increased PVR
pulmonary hypertension is associated with? (2 causes)
Left sided valvular disease (mitral stenosis/regurg) or diseases of hypoxia (ex, OSA)
