Heart Failure (HF) Flashcards
Where does majority of HF begins?
Hint: what side?
L-sided HF
What causes R-sided HF?
Caused by L-sided HF
What happens in systolic HF?
Fluid starts to build up into the pulmonary system
What happens in diastolic HF?
Patients can have normal EF
The L-ventricle becomes stiff and unable to fill properly
What is the Ejection fraction (EF)? What is the normal range?
Measurement of blood leaving the L-ventricle
How much blood the left ventricle pumps out with each contraction.
Normal range: 55-70%
What is the incidence and prevalence of HF?
Most common reason for hospital admission for people > 65 years old
More common in African American individuals under 50 years old than in Euro-Americans
Major cause of disability and death after an MI
What is HF Etiology/Causes HF?
Systemic HTN (heart must work harder resulting in the L-venticle getting thicker)
Coronary artery disease
Structural heart changes
Right-sided HF in absence of left-sided HF often the result of pulmonary problems
What are the s/s of LEFT-sided HF?
Dyspnea (exertional and paraoxsmal noctural)
Fatigue, weakness, arm heaviness
Chest pain or palpitations, skipped beats, fast rate
Oliguria/scant urine
What are s/s of RIGHT HF?
Increased Abdominal girth
Dependent edema
Hepatomegaly
Hepatojugular reflux
Ascities
WEIGHT GAIN (most reliable indictor of fluid gain/loss)
What is R-sided HF associated with?
L-sided HF?
(RIGHT) increase system venous pressures and congestion
(LEFT) Pulmonary congestion/symptoms
What is the cause for concern regarding weight gain?
More than 2 lbs. in a 24-hour period or 5 lbs. in a week
What is Biventricular failure?
Both R and L ventricular dysfunction
Inability of both ventricles to pump effectively
Fluid build-up and venous engorgement
Decreased perfusion to vital organs
What is Acute Decompensated HF (ADHF)?
Increase in pulmonary venous pressure is caused by LV failure.
Engorgement of the pulmonary vascular system.
Alveoli lining cells are disrupted, fluid with RBCs moves into alveoli causing edema
Pulmonary Edema, Cyanotic, Anxious, Pale, RR can be > 30, Wheezing, coughing, orthopnea, Frothy pink sputum, Tachycardia
What are some compensatory mechanisms of HF?
SNS stimulation (increase HR, contractility putting more pressure on the heart)
RAS activation (increased preload and afterload; retention of sodium and water)
Ventricular remodeliing (Myocytes becomes larger and doesn’t contract as well causing problem within the heart —> (sudden cardiac death increases)
What are other compensatory mechanisms?
Myocardial hypertrophy (increased thickening of the heart muscle; caused by HTN)–> Occurs over time where there is not adequate coronary circulation
Dilated Chambers (Muscles within the ventricles begin to stretch leading to dilation; Extra work on the heart)
What are the complications of HF?
Pleural effusion
Dysrhythmias and dyssynchronous contraction
(Atrial and ventricular
Atrial or left ventricular thrombus)
Hepatomegaly
Cardiorenal syndrome
Anemia
What are the important assessment/labs regarding HF?
Echo (GOLD STANDARD); treatment is based off results (can see the size of the ventricles; show EF %) (TEST Q)
BNP (hallmark lab)
Serum electrolytes
What are the mechanical circulatory support devices?
Intra-aortic balloon pump (IABP) –> Short-term solution; when the pt. is hemodynamically unstable
ECMO–> 50% survival rate; critically ill pts. (life support)
VADS–> for critically ill pts, mechanical pump
What is special about a heart transplant?
Gold standard therapy suitable for some patients in end-stage HF
