Lecture 3

Question 1

Heart failure

Answer 1

Failure of the heart to pump blood (CO) at a rate and volume that meets the metabolic needs of the body
Results in pulmonary and systemic venous HTN
- pulmonary congestion/edema –> dyspnea
- peripheral edema
- fluid accumulation in thoracic & abdominal cavities
Compensatory Mechanism Occur

Question 2

What are 4 Compensatory Mechanisms?

Answer 2

1) The Frank-Starling Mechanism
- preload
- contractility
2) Sympathetic stimulation
- increase HR, TPR, afterload
3) RAAS
- Na & water retention
- Increase bV, venous return, preload –> SV
4) Hypertrophy
- Increase ventricular muscle mass

Question 3

Digoxin

Answer 3

Increase force contraction, myocardial contraction

• improve CO, SV, BP
• Narrow ther window

Question 4

What are the other drugs for HF, beside Digoxin?

Answer 4

Diuretics - if fluid
Beta blockers
Ca channel blockers
ACE inhibitors/ARB - if there’s no fluid

Question 5

What is the ther intention for HF drugs?

Answer 5

Increase myocardial contractility
Decrease cardiac workload
Decrease workload the heart has to pump against

Question 6

If digoxin is used with diuretics, this will…

Answer 6

Improve CO and EF

Question 7

3 pathologies that HF is closely tied to?

Answer 7

HTN
DM
CAD

Question 8

What is the mechanism that ACE/ARB works on HF?

Answer 8

Lowers BP, peripheral edema

Increase CO

Question 9

What are the adverse effects of dig?

Answer 9

arrhythmias, PAC/PVC, tacky, fib, AVN block