Heart Failure Case Flashcards
Dec EF causes
Coronary artery dz Chronic pressure overload Dilated CM Chronic volume overload Disorders of rate and rhythm
Preserved EF
Hypertrophy
Restirctive
Pulmonary HFD
Low CO sx (Left sided)
Kidneys - pre-renal azotemia and renal failure
Bowel - malabsorption, ab pain, feel full
Muscle - weakness, easy fatigueability
Brain - confusion, difficulty concentrating
Liver- elevated AST/ALT and jaundice
Asssessment of hypoperfusion and low CO
Low SBP and narrow pulse pressure
Weak thready pulse
Low CO - poor mentation, reudced urine output, mottled skin, cool extremities
Low CO with noraml BP - maintain BP at expense of normal tissue by inc SVR
Pulmonary congestion
LEft sided
Dyspena, wheezing, orthopnea, PND
Right sided edema
Peripheral edema Ascites Weight gain hepatosplenomegaly Polyuria/nocturia Cardiac cirrhosis
Things that cause RHF
Left side failure
Right infarction
Pulmonary dz
Azotemia and hyponatremia
Azotemia - renal perfusion poor in CHF which leads to reeuction in GFR
Hyponatrwmia - non-osmotic stimulus for ADH, water retention
HF exacerbations
Inc metabolic demands
inc circulating volume (inc preload)
inc afterload (including PE)
Impaired contractility
Slow HR
Fatigue
Anorexia
Exertional dyspnea
Poor perfusion
GI malabsorption
Ability to inc CO
PND
Orthopnea
Cough
Symp acitivity and phase of sleep
inc venous return and dec lung volume…liver pushes up diaphragm and less use of accessory muscles
Untied shoes Diaphoresis Labored breathing Blue lips Cold hands
Edema of the feet
Excess SNS
Mudlated by NS
Poor peripheral circulation
Poor circulation
Lowered BP Distended neck veins Dec S1/S2 Holosystolic mmurmur S3
Dec stroke volume and systolic pressure drop
RHF with elevated RA pressure
High end diastolic pressure and dec stroke volume
LV dilated so annulus of AV valve dilated (mitral regurg)
Change in compliacne of ventriclar wall
Irregular irregular pulse Palpable liver edge Pitting edema Basal crackles Dullness in lung fields
A fib due to stretching of muscle wall which impairs ocntractility
Passive congestion of the liver - RHF
Elevated HS pressour, venous congestion, RHF
Congestion of the lungs
IMpaired note to percussion
