MedComplex-CardioVascular2 Flashcards
What is Congestive Heart Failure? Failure of the heart ________.
as a pump
What is the leading discharge diagnosis in hospitalized pt’s over 65 years of age?
Congestive heart failure
CHF is a very common condition with a poor prognosis, with a mortality of more than ___% in less than FIVE years.
50% holy Shit!
CHF is the underlying or contributing cause of death of an estimated ________ individuals annually in the U.S. and for which about _______ patients are currently being treated.
300,000…2 million
The heart has an amazing capacity to adjust its activity to meet the body’s varying needs and acts to maintain ______ pressure and perfusion of vital organs.
arterial
In CHF: The output declines during ____, and markedly increases during ______ by the use of the Cardiac Reserve.
sleep…exercise
Persons with CHF, even at rest, must use their cardiac ______.
reserve
WHAT ARE THE THREE COMPENSATORY MECHANISMS used to prevent CHF?
1.Increased Sympathetic Stimulation 2.Fluid Retention 3.Cardiac Muscle Hypertrophy
CHF Comp. Mech #1: Increased Sympathetic Stimulation-Increases both the heart rate and myocardial contractility by release of _________.
Norepinephrine
CHF Comp. Mech #1: Increased Sympathetic Stimulation- In severe CHF, the hearts metabolic needs increase with the increased sympathetic stimulation, leading to myocardial ischemia and _______ when the coronary blood flow is not adequate to meet the hearts needs.
Angina
CHF Comp. Mech #2: Fluid Retention - As cardiac output starts to fall to a point where renal blood flow is decreased, the _____ is activated, increasing the ______ and _____ retention.
RAS…sodium and water
CHF Comp. Mech #2: Fluid Retention - The fluid retained by the _______ causes a progressive increase in the vascular volume with an accompanying increase in ______ return to the heart, leading to increased filling and stretching of the myocardium (chamber dilation)
kidneys…venous
CHF Comp. Mech #2: Fluid Retention - The increased _____ or dilation helps to sustain cardiac performance by enhancing contractility.
preload
CHF Comp. Mech #2: Fluid Retention - The increase in vascular volume, as failure progresses, leads to _____.
edema
CHF Comp. Mech #3: Cardiac Muscle Hypertrophy- It is a compensatory response of the myocardium to increased _______ work.
mechanical
CHF Comp. Mech #3: Cardiac Muscle Hypertrophy- Volume-__________ ventricles develop hypertrophy accompanied by dilation with increased ventricular diameters.
overloaded
CHF Comp. Mech #3: Cardiac Muscle Hypertrophy- The hearts usually range up to about _____ grams.
600g (normal about 300f, 450m)
CHF-the myocardial hypertrophy, along with the increased SNS stimulation, may lead to _______ or angina of the heart
ischemia
Pathophys of CHF-Characterized by diminished cardiac output (________ failure) or damming back of blood in the venous system (_______ failure), or both.
forward…backward
Pathophys of CHF - ______ failure impairs movement of blood into the vessels emerging from the heart.
forward
Pathophys of CHF- Backward failure allows blood to accumulate in the vessels or heart chambers located behind the failing ______ and results in congestion of the pulmonary and venous system circulation.
ventricles
LEFT Heart Failure-Pathophysiology - Most often caused by ischemic heart disease, ____, aortic and mitral valve disease, and non-ischemic myocardial disease (myocarditis)
HYPERTENSION
LEFT Heart Failure-Pathophysiology - The morphologic and clinical effects primarily results from progressive damming of blood within the _______ circulation and the consequences of diminished peripheral blood flow.
pulmonary
LEFT Heart Failure-Pathophysiology - The left ______ is usually hypertrophied with massive chamber dilation, with secondary enlargement of the left ______.
ventricle…atrium
