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AAP Upskill > LVAD and HF > Flashcards

LVAD and HF Flashcards

1
Q

What is the purpose of an LVAD?

A
  • To correct a left ventricular problem
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2
Q

Where does an LVAD pump blood too?

A

From the left ventricle of the heart, to the aorta and around the body.

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3
Q

What is the LVAD powered by?

A

External batteries.

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4
Q

What is the average blood pressure of someone fitted with an LVAD?

A

60-90 systolic

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5
Q

What are the major health risk to LVAD fitted patients?

A
  • Stroke
  • DVT
  • Infection
  • PE
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6
Q

What does an LVAD rescue pack include?

A
  • Spare batteries
  • Spare controller
  • Power lead
  • LVAD contact card
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7
Q

What alteration in the circulation section of medical patient assessment needs to be made for an LVAD patient?

A
  • Auscultion over the heart to listen for humming and alarms.
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8
Q

What is a mean BP?

A

The average BP between the systolic and the diastolic.

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9
Q

Define “Atrophy”.

A

The wastage of muscle.

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10
Q

Define “Hypertrophy”.

A

The growth of muscle.

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11
Q

What is the impact of left ventricular hypertrophy?

A
  • Increased muscle mass reduces the chamber size, due to the limited space in the thoracic cavity.
  • Reduced capacity, reduces the stroke volume from the left ventricle.
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12
Q

How is stroke volume calculated?

A

SV = Preload + contractility - afterload

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13
Q

How is cardiac output calculated?

A

CO = Stroke volume x heart rate

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14
Q

Define “Heart failure”.

A

A Clinical syndrome characterised by several signs and symptoms, where the left ventricle isn’t pumping blood properly.

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15
Q

What are the common causes or heart failure?

A
  • Coronary heart disease
  • MI near or in/near/around left ventricle
  • Reduced valve effectiveness
  • Rhythmic changes
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16
Q

What is the result of valve stenosis?

A
  • Causes the valve to not fully open/close
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17
Q

Where does heart failure occur?

A
  • Right and left ventricles
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18
Q

What might mask Right ventricular heart failure?

A
  • Left ventricular heart failure.
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19
Q

Define “Remodelling”

A

Where tissue regrow into a slightly different shape, altering the function/ ability to complete a function.

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20
Q

What would increase to maintain cardiac output, in cases of acute heart failure?

A
  • Heart rate, as stroke volume reduced.
21
Q

What occurs when there is a reduced volume in the left ventricle.

A

Back flow into the left atrium and pulmonary vein. Leading to increased hydrostatic pressure, and fluid returning back into the alveoli.

22
Q

What are the backward effects of heart failure?

A
  • Reduced left ventricular emptying
  • Increased pressure in the left atrium
  • Volume and pressure increase in the pulmonary veins and capillaries
  • Fluid leaks into the alveoli
23
Q

What are the forward effects of heat failure?

A
  • Reduced cardiac output
  • Reduced perfusion at the tissues
  • Reduced blood flow at the kidneys
  • Increased reabsorption of sodium and water
24
Q

What are the signs and symptoms of heart failure?

A
  • Dyspnoea
  • Orthopnoea
  • Tachycardia
  • cough
  • Fatigue
  • Dizziness
  • Cyanosis
  • Crackles/ wheeze
25
Q

Define “Orthopnoea”.

A

Difficulty in breathing caused by patient positioning.

26
Q

Why do Heart failure patients suffer from orthopnoea?

A
  • When laid flat surface area of the lungs reduce.
  • Fluid subsequently covers a great area of the capillary bed.
27
Q

Define “Proximal Nocturnal Dyspnoea”.

A

Difficulty in breathing that occurs at night.

28
Q

What are the common causes of right heart failure?

A
  • COPD
  • PE
  • LHF
  • Heart valve disease
29
Q

In right ventricular heart failure, where does oedema occur?

A
  • in the major organs.
30
Q

What may occur in right ventricular heart failure?

A
  • Pitting oedema in the lower limbs
  • Difficulty in breathing due to acieties
  • Distended jugular veins
  • Enlargement of the organs.
31
Q

What is given to reduced major organ enlargement caused by right heart failure.

A

Steriods

32
Q

What are the potential triggers for exacerbation of heart failure?

A
  • MI
  • Pericarditis
  • Pneumonia
  • PE
  • Hypertension
  • DVT
  • ACS
  • Tachy/ Brady
  • Non compliance in medicaation
33
Q

What acute presentation can be expected in exacerbation of left ventricular heart failure?

A
  • Pulmonary oedema
  • Increased dyspnoea without peripheral oedema
34
Q

What acute presentation might be expected in an exacerbation of right ventricular heart failure?

A
  • Prominent peripheral oedema
35
Q

What is the function of an ICD?

A
  • To correct a shockable arrhythmia
  • To pace bradycardia
36
Q

What kind of pacing is used for VT pacing?

A

Anti-tachycardia pacing

37
Q

What kind of shocks that are delivered by an ICD?

A

Biphasic shocks

38
Q

What is CRT in reference to heart failure managment?

A

Cardiac resynchranisation therapy

39
Q

Where may an an ICD be fitted?

A
  • Left subcalvian
  • Mid auxilla
40
Q

How many times would a ICD discharge?

A
  • 8 times after a shockable rhythm is detected
41
Q

What Joule does an ICD shock at?

A

40J

42
Q

What may a fractured or damage lead cause?

A
  • Accident discharge of shock
  • No shock when patient is in a shockable rhythm
43
Q

How far away from an ICD should an AED pad be placed?

A

8cm

44
Q

What is the purpose of a magnet in the management of an ICD?

A
  • To disable to the shock capacity of the ICD
45
Q

When should a magnet be used?

A

A magnet should be used once the rhythm for which shocks are being delivered has been taken

46
Q

What needs to be done if the shock delivered by the ICD is inappropriate?

A
  • Record the rhythm
  • Disable ICD with magnet
  • Monitor
  • Support as appropriate
47
Q

If an arrhythmia is prsent and the ICD is not working, what is the appropriate plan of action?

A
  • Record the rhythm
  • Determine the rhythm
  • Support and transport PT has the condition presents
48
Q

If the PT is in SVT and haemodynamically stable, what is the appropriate treatment plan?

A

Disable the ICD with a magnet

AAP Upskill (28 decks)

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