HLTH 2501: congestive heart failure

Question 1

what is CHF?

Answer 1

occurs when the body is unable to pump sufficient blood to meet the metabolic needs of the body; one side of the heart usually fails first, followed by the other side

Question 2

what are the causes of CHF?

Answer 2

usually are results of complication of another conditions, but also can be the result of a valve defect, hypertension, or lung disease

Question 3

what is the main compensation mechanism for CHF?

Answer 3

to maintain cardiac output

Question 4

how is cardiac output maintained in CHF?

Answer 4

increased renin and aldosterone secretion, SNS activation, and dilation or the heart chambers, along with hypertrophy of the ventricle walls

Question 5

cardiomegaly

Answer 5

the walls of the ventricle become thicker as a compensation mechanism for CHF

Question 6

two basic effects when the heart cannot maintain its pumping capability

Answer 6

cardiac output or stroke volume decreases and backup congestion develops

Question 7

what happens when myocardial cells die?

Answer 7

they are replaced with fibrous tissue

Question 8

what happens when CO and SV decrease?

Answer 8

less blood reaches other organs and tissues, leading to decreased cell function, fatigue, and mild acidosis

Question 9

what is backup congestion?

Answer 9

occurs in the circulation behind the affected ventricle when the output from the ventricle is less than the inflow of blood

Question 10

left-sided CHF

Answer 10

occurs when the left ventricle cannot pump all its blood into the systemic circulation, causing the normal volume of blood returning from the lungs to not be able to enter the left side of the heart; this causes congestion in the pulmonary circulation and possible pulmonary edema

Question 11

right-sided CHF

Answer 11

the right ventricle cannot maintain its output, so less blood proceeds to the left side of the heart and the systemic circulation; congestion often occurs in the legs, feet, and portal circulation

Question 12

forward effect signs and symptoms of CHF

Answer 12

fatigue, weakness, dizziness, dyspnea, exercise intolerance, and cold intolerance

Question 13

dyspnea

Answer 13

shortness of breath

Question 14

what is the leading cause of CHF

Answer 14

coronary artery disease

Question 15

how would hypertension cause CHF?

Answer 15

it increases diastolic pressure, requiring the left ventricle to contract with more force to open the aortic valve; this cause the left ventricle to hypertrophy and eventually fail

Question 16

what is right-sided CHF often caused by?

Answer 16

pulmonary disease

Question 17

cor pulmonale

Answer 17

right-sided CHF due to pulmonary disease

Question 18

compensation mechanisms effects of CHF

Answer 18

tachycardia, pallor, and daytime oliguria

Question 19

daytime oliguria

Answer 19

decreased urinary output

Question 20

backup effects of left-sided HCF

Answer 20

dyspnea when lying down (fluid accumulates in the lungs), cough due to fluid irritating the respiratory passages, and paroxysmal nocturnal dyspnea

Question 21

paroxysmal nocturnal dyspnea

Answer 21

occurs during sleep when the increased blood volume in the lungs leads to increased fluid in the alveoli, leading to interference with O2 diffusion and lung expansion; can cause the individual to awake in a panic struggling for air and having hemoptysis

Question 22

hemoptysis

Answer 22

coughing up blood from your lungs

Question 23

backup effects of right-sided CHF

Answer 23

edema in the feet, legs, or butt, hepatomegaly, splenomegaly, ascites, flushed face, distended neck veins, headache, and visual disturbances (as a result of acute-right sided failure)

Question 24

ascites

Answer 24

fluid accumulates in the peritoneal cavity; associated with right-sided CHF

Question 25

young children with CHF

Answer 25

often is secondary to congenital heart disease; signs include feeding difficulties, difficulty gaining weight, short sleep periods, irritability, cough, wheezing, and flared nostrils; a third heart sound may also be present

Question 26

gallop rhythm

Answer 26

a third heart sound; sometimes occurs in infants with CHF

Question 27

tests for CHF

Answer 27

radiographs show fluid in the lungs, cardiac aterhization monitor pressure in the circulation, and arterial blood gases measure hypoxia

Question 28

lifestyle changes for treating CHF

Answer 28

is aimed at reducing the workload on the heart by avoiding excessive fatigue, stress, and sudden exertion; influenza vaccines can prevent respiratory infections, diet changes focus on decreasing sodium and cholesterol, and increasing waster, protein, and iron

Question 29

drug treatment for CHF

Answer 29

antianxiety drugs, ACE inhibitors, digoxin, antihypertensives, and diuretics are all commonly used