Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Cardio Exam 1 > Lec 5 Heart Failure I > Flashcards

Lec 5 Heart Failure I Flashcards

1
Q

What is definition of heart failure?

A

cardiac disorder that impairs ability of ventricles to eject blood [fwd failure] or fill with blood [backward failure] or both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is equation for CO?

A

CO = HR * SV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What 3 factors can affect stroke volume?

A
  • preload
  • afterload
  • contractility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are signs of systolic CHF?

A
  • decreased CO
  • decrease LVEF [left ventricular ejection fraction] < 50% normal

poor contractility
often 2ndary to ischemic heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are signs of diastolic HF?

A
  • normal LVEF [left ventricular ejection fraction]
  • high LV, RV, end-diastolic pressures

normal contractility, impaired relaxation, impaired compliance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

If you see decreased ejection fraction (<50% normal) what possible causes of the heart failure?

A

decreased EF –> decreased contractility or increased afterload

if impaired contractility:

  • MI
  • chronic volume overload [aortic or mitral regurgitation]
  • dilated cardiomyopathy [DCM]

if increased afterload:

  • AS [aortic stenosis]
  • HTN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is equation for ejection fraction?

A

EF = SV / EDV

SV = EDV - ESV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

If you see normal ejection fraction in heart failure what possible causes?

A

due to impaired diastolic filling

  • LV hypertrophy
  • restrictive cardiomyopathy
  • myocardial fibrosis
  • pericardial tamponade
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are 3 compensatory mech in heart failure?

A
  • frank-starling mech
  • ventricular hypertrophy
  • neurohormonal activation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does heart failure change starling curve?

A
  • in heart failure:
  • — shift right in curve [decreased contractility]
  • — move right along new HF curve [compensatory try to increase stroke volume/pressure at cost of increasing congestion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is equation for wall stress?

A

wall stress = pressure * radius / thickness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does ventricular hypertrophy help failing ventricle?

A

increased thickness –> decreased wall stress of ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What kind of ventricular hypertrophy if there is volume overload?

A

eccentric hypertrophy = new sarcomeres in series with old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What kind of ventricular hypertrophy if there is pressure overload?

A

concentric hypertrophy = new sarcomeres in parallel with old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What compensatory mech in HF?

A

hypertrophy –> increase ventricular mass –> increase atrial pressure

frank-starling –> increase ventricular end diastolic volume –> increase atrial pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 3 neurohormonal systems that are compensatory mech in heart failure?

A
  • adrenergic nervous system [sympathetic]
  • RAAS
  • ADH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is equation for systemic vascular resistance?

A

BP [svr] = CO * TPR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are clinical symptoms of left sided heart failure?

A
  • dyspnea
  • orthopnea [SOB when lie flat]
  • cough
  • PND [Paroxysmal nocturnal dyspnea]
  • fatigue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are clinical symptoms of right sided heart failure?

A
  • edema
  • right upper quadrant pain
  • anorexia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are clinical findings of left ventricle failure?

A
  • tachycardia
  • pleural effusion
  • systolic/diastolic dysfunction [S3/S4]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are clinical findings of right ventricle failure?

A
  • JVD
  • hepatomegaly
  • peripheral edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is first heart sound [S1]? Where is it loudest?

A

mitral and tricuspid valve closure

loudest at mitral area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is 2nd heart sound [S2]?

A

aortic and pulmonary valve closure

loudest at left sternal border

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is 3rd heart sound [S3]?

A

in early diastole during rapid ventricular filling phase

associated with increased filling pressure and more common in dilated ventricles

25
What is 4th heart sound [S4]?
atrial kick in late diastole high atrial pressure, associated with ventricular hypertrophy
26
What are 4 stages of chronic HF?
Stage A: high risk of HF without structural heart disease or symptoms Stage B: heart disease with asymptomatic LV dysfunction Stage C: prior or current symptoms of HF with structural heart disease Stage D: advanced heart disease and severely symptomatic or refractory HF
27
Why do you check CBC lab in CHF?
to check for anemia
28
Why do you check electrolyte/creatine lab in CHF?
before you start high dose diuretic
29
Why do you check fasting glucose lab in CHF?
diabetes can contribute to CHF
30
Why do you check thyroid function lab in CHF?
thyrotoxicosis and hypothyroidism can cause CHF
31
Why do you check iron lab in CHF?
check for hereditary hemochromatosis
32
Why do you check ANA [antinuclear antibody] lab in CHF?
check for autoimmune [SLE = lupus]
33
Why do you check viral studies in CHF?
check for viral myocarditis
34
Why do you check BNP lab in CHF?
usually elevates (>400) in pt with HF
35
What should you look for in HF chest xray?
- cardiomegaly - vascular redistribution interstitial edema - alveolar edema - pleural effusion
36
What should you look for in EKG in HF?
- ischemic heart disease - 1st AV block, left anterior fascicular block - amylodidosis - idiopathic dilated cardiomyopathy [LVH]
37
What should you look for in echo in HF?
- get ejection fraction to help determine what type of HF | - tells you about structure/function of LV/RV and valves
38
When should you do coronary artery angiogram in HF? WHat does it tell you?
- in pt with HF and angina or significant ischemia or suspected CAD measures CO, LV dysfunction, LV end diastolic pressure
39
How do you treat pulmonary/systemic congestion?
give diuretic = get rid of fluid
40
How do you treat low cardiac output in HF?
give vasodilator or ionotropic drugs
41
What is action/use of diuretics?
- promote elimination Na and water via kidney - reduces venous return to heart and relieves pulmonary congestion -- no mortality benefits just provides symptomatic relief
42
What happens if over diuresis?
fall in CO
43
What is action of nitrates?
- venous vasodilators | - increase venous pooling, decrease venous return to heart
44
What is action of hydralazine?
- arteriolar vasodilators - decreases systemic vascular resistance [SVR] - decreases LV afterload - increases stroke volume
45
What is action of ACEI/ARBs?
arteriolar and venous dilators
46
What is action of ace inhibitors?
- inhibit formation angiotensin II and decreases aldosterone | - improves Na elimination --> decreased intravascular volume
47
What should you use if ace inhibitor not tolerated?
ARB
48
What is action of beta blockers?
improve overall and event free survival in class 2, 3, 4 CHF
49
What are contraindications of beta blockers?
- HR < 60/min - symptomatic bradycardia - peripheral hypoperfusion - COPD/asthma - 2nd or 3rd degree AV block
50
What is digoxin?
inhibits Na/K ATPase causing indirect inhibition Na/Ca exhanger - increases intracellular Ca - increased contractility - use to control HF symptoms - decrease hospitalizations in HF - no benefit to mortality
51
What are possible inotropes in HF?
- digoxin - phosphodiesterase inhibitiors - beta agonists
52
What is action of spironolactone and eplerenone?
- aldosterone antagonists | - increase diuresis, improve survival CHF
53
What is use of implantable defibrillator in HF?
- mortality of HF due to sudden cardiac death caused by arrhythmias - increases survival benefit esp with cardiomyopathy and LVEF
54
What is use of cardiac resyncronization?
- increases LV systolic function - increase exercise capacity - decrease frequency of HF exacerbation
55
What do you use to treat diastolic HF dysfunction?
- problem is not a weak pump its a stiff un-relaxing pump - treat underlying HTN or pericardiectomy - don't give inotrope, be careful with diuretic
56
What is acute decompensated HF?
fluid goes into lungs secondary to high LA pressure and pulm venous and capillary pressures --> cardiogenic pulmonary edema
57
What are causes of acute decompensated HF?
- acute mechanical event: rupture chordae tendinae/acute MR - volume overload - valvular defect [aortic stenosis]
58
How do you treat acute decompensated HF?
LMNOP - Loop diuretic - Morphine - nitroglycerine [vasodilator] - Oxygen - positive pressure ventilation

Cardio Exam 1 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions