Hemodynamics review Flashcards
Define Preload
How much the ventricles have to stretch in order for the heart to fill up
What are the two types of preloads we measure?
Preload of right ventricle
Preload of left ventricle
When measuring the right ventricle’s preload, what do we call it?
CVP = right ventricle preload
If we measure the left ventricles preload, what do we refer to it as?
PCWP (wedge pressure) of left ventricle
Your patient says they were exercising outside today. What did that to the heart function?
Due to them exercising, their preload would increase.
The doctor says your patient is hypervolemic. What does this do their heart functioning?
Being hypervolemic means having too much fluid - which increases preload.
Your patient reports that someone scared them and caused them to fall. What did this do to the heart functioning?
Due to being scared, their sympathetic tone was increased and so the preload increased.
You have a patient with an AV fistula. What does this do to their heart functioning?
The AV fistula allows blood to bypass and shunt. So, this overall increases preload.
What examples increase preload?
Exercise
Hypervolemia
Fight or flight/sympathetic tone
AV fistulas
Your read that the patient is hypovolemic. What does this do their heart’s functioning?
Due to being dry, their preload is decreased.
(note: it can also decrease afterload as well)
Patient has a history of stenotic valves. What does this do their hearts functioning?
The stenosis causes less blood to be able to pass into the heart’s ventricles, so it decreases preload.
You are taking care of an A.fib patient. What does this mean for their heart functioning?
Their preload is decreased due to loss of the ability to fill adequately
Examples that decrease preload
Hypovolemia
Stenosis of tricuspid/mitral valves
A. fib
Define Afterload
Afterload is the force the left ventricle has to overcome in order to eject blood
Patient comes in with hypertension. What does this mean for their heart functioning?
Due to a high BP, the afterload requirements increase.
Results come back from the echo that the patient has Aortic Stenosis. What will this do the heart functioning? (be specific)
Since the aorta is directly tied to afterload, it being stenotic means there will be an increase in afterload needed.
Patient labs show the patient recently suffered an MI. What does this mean for their heart functioning?
An MI causes the heart to not be able to push the body with blood as well. This means the afterload increases.
Patient of yours has polycythemia. What does this do to their heart functioning?
This means their blood is thicker. And that would require an increase in afterload.
Examples that increase afterload?
High SVR or Blood pressure
Aortic stenosis
Myocardial Infarction
Polycythemia
Your patient has hypovolemia. What does this to to their afterload?
Hypovolemia will cause a decrease in afterload.
(it can also cause an decrease in preload)
Your patient has septic shock. What does this do to their heart functioning?
The septic shock causes a decrease in resistance so afterload will decrease.
Patient has hx of end stage cirrhosis. What does this do to their heart functioning?
End stage cirrhosis is of the liver but it can affect the kidneys. And so, the afterload will decrease.
You have a patient taking nitrates/CBB/ace/arbs/ what does this do to heart functioning?
The vasodilators will decrease afterload due to lowering the resistance.
If your patient has cirrhosis, what symptoms can you look for ?
Jaundice
Decrease UO
Anemic
Bilirubin scabs
If your patient has any form of shock, what symptoms can you look for?
Hypotension paired with Tachycardia
Decreased cap refill
Decrease UO
Edema
Labs to check for cirrhosis
ASLT
BUN
CR
WBC
Lact
Define Contractility
The contraction’s strength
Define Inotropic
Force of energy of the contraction
Define Chronotropic
Time related, HR
Define stroke volume
Amount of blood ejected by the ventricles during during a contraction
Define Cardiac Output
Amount of blood pumped by the heart measured in Liters for one minute
Define Cardiac Index
Amount of blood pumped by the heart in L/minute but is more accurate due to surface area being used
