Lecture 8- heart failure

Question 1

types of heart failure

Answer 1

high output failure
low output failure
systolic failure
diastolic failure

Question 2

systolic dysfunction

Answer 2

decrease in myocardial contractility
ejection fraction less than 40% (should be 65%)
causes- ischemic heart disease, cardiomyopathy, hypertension

Question 3

deleterious consequence of systolic dysfunction

Answer 3

pulmonary or peripheral edema

Question 4

diastolic dysfunction

Answer 4

smaller ventricular size, impaired filling

any condition that impedes expansion of ventricle, increase thickness, or delays diastolic relaxation

Question 5

right heart failure

Answer 5

congestion of peripheral tissue
GI tract congestion
liver congestion

Question 6

left heart failure

Answer 6

depressed cardiac output

pulmonary congestion

Question 7

frank sterling mechanism

Answer 7

increase in muscle stretch causes increase wall tension therefore increase myocardial oxygen consumption and demand

Question 8

compensatory mechanisms during heart failure

Answer 8

1. frank sterlings
2. RAA
3. sympathetic NS
4. natriuretic peptides (high in pt w heart failure)
5. endothelins
6. inflammatory mediators

Question 9

endothelins

Answer 9

vasoconstrictor

decreases lumen

Question 10

nocturia

Answer 10

need to wake up and pass urine during the night

Question 11

dyspnea

Answer 11

difficulty breathing

Question 12

orthopnea

Answer 12

not being able to breathe while laying down, must sit up

Question 13

cachexia

Answer 13

tissue wasting

Question 14

central cyanosis

Answer 14

tongue and lips are blue, extremities warm

Question 15

peripheral cyanosis

Answer 15

poor circulation is extremities

Question 16

treatment for CHF

Answer 16

diuretic
digitalis
ACE inhibitor
beta blocker
oxygen therapy

Question 17

intraortic balloon pumping

Answer 17

for Pt waiting on heart transplant
coronary artery blood flow increased
perfusion increased

Question 18

VAD

Answer 18

ventricular assist device

1 end on aorta, 1 end on ventricle

Question 19

cardiomyopathy

Answer 19

genetic
mixed
acquired

Question 20

hypertrophic cardiomyopathy

Answer 20

growth and arrangement of cardiac muscle fibers are abnormal, leading to wall thickness
usually thickening of septum
genetic

Question 21

symptoms & treatment for hypertrophic cardiomyopathy

Answer 21

usually no symptoms
dyspnea, fainting, strong rapid beats

drugs to reduce pumping action

Question 22

ARVC/D

Answer 22

mutation in myocardium that can lead to loss of myocites replaced by fat

Question 23

dilated myopathy

Answer 23

gradually enlarges heart and weakens pumping
thinning of walls
no def cause
can be linked to- excessive alcohol consumption, viral infection, toxins

Question 24

symptoms & treatment for dilated cardiomyopathy

Answer 24

usually no symptoms
in adv, can cause pain
increase EDV and ESV

relieving symptoms
digoxins and diuretics

Question 25

restrictive cardiomyopathy

Answer 25

ventricular filling is restricted, walls are rigid therefore reducing lumen

Question 26

symptoms & treatment for restrictive cardiomyopathy

Answer 26

weakness, fatigue, breathlessness
edema, nausea, bloating

focused on treating cause

Question 27

acquired cardiomyopathy

Answer 27

aka myocarditis
peripartum- after giving birth
inflame of myocardium

Question 28

stress cardiomyopathy

Answer 28

left ventricular ballooning due to emotional stress

impaired ventricular contractility

Question 29

surgical treatment for heart failure

Answer 29

intraortic balloon pumping
VAD
heart transplant