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PSIO 485 Exam 04 > Lecture 17: Heart Failure > Flashcards

Lecture 17: Heart Failure Flashcards

1
Q

What is “Heart Failure?”

A
  • The inability of the CO to keep pace with the body’s demands for supplies and removal of wastes
  • either one or both ventricles may progressively weaken and fail
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2
Q

What is majority cause of heart failure?

A

Dysfunction of the left ventricle

systolic and diastolic heart failure

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3
Q

The ____ ventricle also may be dysfunctional especially in ____ disease (_____ _____ failure)

A

right

pulmonary (right ventricle)

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4
Q

What are the Compensatory Measure’s first step?

A

sympathetic activity to the heart is reflexly increased

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5
Q

What are the Compensatory Measure’s second step?

A

when CO is reduced, the kidneys, attempt to improve their reduced blood flow, retain extra salt and water in the body during urine formation to expand the blood volume

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6
Q

What is Class I?

A
  • No limitation is experienced in any activities

- no symptoms from ordinary activities

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7
Q

What is Class II?

A
  • Slight, mild limitations of activity

- the patient is comfortable at rest or with mild exertion

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8
Q

What is Class III?

A

Marked limitation of any activity

the patient is comfortable only at rest

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9
Q

What is Class IV?

A

Any physical activity brings on discomfort and symptoms occur at rest

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10
Q

What is Stage A?

A
  • high risk HF in future

- no symptoms at any stage

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11
Q

What is Stage B?

A
  • A structural heart disorder

- no symptoms at any stage

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12
Q

What is Stage C?

A
  • Previous or current symptoms of HF in the context of underlying structural heart problem
  • managed with medical treatment
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13
Q

What is Stage D?

A
  • Advanced disease requiring hospital-based support

- heart transplant or palliative care

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14
Q

As the disease progresses and the contractility of the heart deteriorates further, the heart reaches a point at which it is no longer able to pump out a normal Stroke Volume despite compensatory measures is called:

A

Decompensated Heart Failure

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15
Q

What is Left Sided Failure?

A

Backwards failure of the left side leads to pulmonary edema because blood dams up in the lungs

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16
Q

Right sided failure has more serious consequences than Left sided failure.
T/F

A

False, Left side is more serious than right

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17
Q

What is “Systolic Left Heart Failure?”

A

an inability of the heart to generate an adequate CO to perfuse vital tissues

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18
Q

Clinical Manifestations
The clinical manifestations of ____ heart failure are the result of ______ ________ congestion and inadequate perfusion of the _______ circulation

A

right
pulmonary vascular
sympathetic

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19
Q

Clinical Manifestations

Individuals experiences:

A
  • Dyspnea
  • Orthopnea
  • Cough of frothy sputum
  • Fatigue
  • Decreased Urine output
  • Edema
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20
Q

Decreasing _____, increasing _____ and _____, as well as blocking the ______ mediators of myocardial toxicity, this will mange systolic left heart failure.

A

contractility, preload; afterload

neurohumoral

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21
Q

These 3 things improve myocardial oxygenation:

A
  • Oxygen
  • Nitrates
  • Morphine
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22
Q

These increase contractility and can help raise the blood pressure in hypotensive individuals:

A

Intravenous Inotropic drugs

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23
Q

These reduce preload:

These reduce both preload and afterload by decreasing aldosterone levels and reducing PVR?

A

Diuretics

ACE Inhibitors

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24
Q

This short acting drug helps reduce mortality:

A

Intravenous Beta-Blockers

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25
Q

This intravenous administration of this to the brain also improves preload and contractility

A

Natriuretic peptide (Nesirtide)

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26
Q

Individuals may benefit from either of these:

A

Acute Coronary Bypass

Percutaneous Coronary Intervention

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27
Q

What is Acute Decompensated Heart Failure (ADHF)?

A

Worsening signs and symptoms of heart failure

28
Q

what symptoms are associated with ADHF?

A

Difficulty Breathing
Legs or Feet Swelling
Fatigue

29
Q

What is Acute Heart Failure?

A

sudden onset of left ventricular failure of an acute primary event

30
Q

The most common precipitating factor of AHF is:

A

Myocardial Infarction

31
Q

What is Forward Failure? what causes it?

A

Decreased CO related to Decreased Renal Blood Flow

- It is due to altered glomerular filtration with retention of water and salt

32
Q

What is Backward Failure?

A

Increased Filling pressure of ventricles due to obstruction

-occurs with mitral or tricuspid stenosis, which causes increased venous pressure with congestion

33
Q

Left sided Heart Failure occurs:

A

By HBP or CAD

34
Q

What happens to a person with left sided heart failure of the follow?
A) Preload
B) Afterload
C) Contractility

A

A) Increases
B) Increases
C) Decreases

35
Q

Catecholamine
Prepares body for physical activity
- increases __, __, and ___ ____
- secreted into urine after breaking down and can detect_______

A

HR, BP, Blood Glucose

Phenochromocytoma

36
Q

Renin-Angiotensin

Regulation of _____ ______ concenctration and arterial ____.

A

Plasma Sodium

BP

37
Q

Aldosterone

Stimulates ____ secretion, _____ and water reabsorption from the gut

A

Potassium

Sodium

38
Q

Antidiuretic Hormone
Conserves _____.
AVP is :

A

water

Arginine Vasopressin

39
Q

Endotoxin are

A

small, stable, bacterially-derived hydrophobic molecules

40
Q

Cytokines are

A

signaling molecules that mediate and regulate immunity, inflammation and hematopoiesis

41
Q

Diastolic Heart Failure

this is defined as

A

pulmonary congestion despite a normal SV and CO

42
Q

Diastolic Heart Failure
Results from decreased ______ of the left ventricle and abnormal ___ ____ such that a normal ____ results in an increased _____

A

compliance;
diastolic relaxation
LVEDV
LVEDP

43
Q

What treatments would help diastolic failure?

A

Control BP and HR
Treat symptoms of HF
Reduce symptoms of CAD

44
Q

Right Heart Failure
Results from left ___ ____ when the increase in the left ventricle ___ ____ that is reflected back into the _____ ______ is severe enough

A

heart failure
filling pressure
pulmonary circulation

45
Q

Right Heart Failure

As pressure in the ____ _____ rises, the ____ to the right ventricular ____ increases

A

pulmonary circulation, resistance emptying

46
Q

Right Heart Failure

The right ventricle is _____ prepared to compensate for this increased ____ and will ____ and ____.

A

poorly
workload
dilate and fail

47
Q

Pulmonary Hypertension

Can be caused by a number of factors, all of which forces the heart’s ___ ___ to work ____ to pump blood to the ______

A

right side
harder
lungs

48
Q

Pulmonary Hypertension

The right chamber may ____ as they struggle to function and ___ is often forced ____ through the ______ valve

A

enlarge
blood
backwards
tricuspid

49
Q

Right Heart Failure

When this happens, ____ will rise in the systemic ____ _____, resulting in ____ ______ and _______

A

pressure
venous circulation
peripheral Edema
Hepatosplenomeagaly

50
Q

High Output Failure

Is the inability of the heart to

A

adequately supply the body with blood borne nutrients, despite adequate blood volume and normal or elevated myocardial contractility

51
Q

Common causes of High-output failure are

Hint: ASHB

A
  • Anemia
  • Septicemia
  • Hyperthyroidism
  • Beri-Beri
52
Q

Anemia:

A
  • Decreases oxygen carrying capacity to the blood
53
Q

Anemia

____ ____ occurs as the body’s cells switch to _____ metabolism

A

metabolic acidosis

anaerobic

54
Q

Anemia

in response to metabolic acidosis, HR and SV _____ in attempt to circulate blood ____.

A

increases

faster

55
Q

Anemia

If anemia is ___, maximum CO does not supply the cells with enough ____ for metabolism

A

severe

oxygen

56
Q

Septicemia

during metabolism, _____ ____ and the ____ process cause systemic _____ and _____.

A

bacterial toxins; inflammatory

vasodilation; fever

57
Q

Septicemia

In overwhelming septicemia, the ___ may not be able to raise its ____ enough to compensate for ______

A

heart; output

vasodilation

58
Q

Septicemia

Body tissues show signs of inadequate ___ ___ despite a very high ___ ___

A

blood supply

cardiac output

59
Q

Hyperthyroidism
This accelerates ___ ____ through the actions of elevated levels of ____ from the thyroid gland. This may occur chronically (_____) or acutely (____ _____)

A

cellular metabolism
thyroxine
thyrotoxicosis
thyroid storm

60
Q

Beri-Beri

This condition is usually caused by malnutrition of ______ and secondary to chronic _____

A

thiamine; alcoholism

61
Q

Reversible treatment of CHF include:

A

Exercise
eating healthy foods
reduction in salty foods
abstinence of smoking and drinking alcohol

62
Q

Drugs that can help with heart failure are:

A
  • Diuretics agents
  • Vasodilators agents
  • Positive inotropes
  • ACE inhibitors
  • Beta Blockers
  • Aldosterone antagonist
63
Q

Cardiac Resynchronization Therapy may help patients that have:

A
  • Class III or IV
  • LVEF of >35%
  • QRS interval < 120 ms
64
Q

CRT involves

A

pacing both left and right ventricles though implantation of a bi-ventricular pacemaker or surgical remodeling of the heart

65
Q

The final option, if all other measure fail is

A

cardiac transplant or implantation of an artificial heart

66
Q

A new type of surgery invented by a Brazilian doctor in 1994 involves a removal of a ____ of the left ventricle, to make ______ more efficient and prevent ____ of blood into the left atrium through the ______ valve

A

swath
contractions
backflow
bicuspid

PSIO 485 Exam 04 (7 decks)

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