Mod7 (heart failure)

Question 1

Heart Failure

Answer 1

inability of heart to deliver a supply of oxygenated blood sufficient to meet the metabolic needs of peripheral tissue (or the ability to do so ONLY if cardiac filling pressures are abnormally high); **assoc with VENTRICULAR function

Question 2

Cardiac failure

Answer 2

result of etiologies that cause impaired ventricular contraction, increased afterload or impaired ventricular filling

Question 3

Cardiac output

Answer 3

volume of blood ejected from ventricle per minute and established by body based on metabolic needs (CO= SV X HR)

Question 4

Systolic Dysfunction

Answer 4

heart unable to EJECT blood from ventricles due to impaired contractility or pressure overload

Question 5

Diastolic Dysfunction

Answer 5

heart unable to relax or fill normally due to increased ventricular wall thickness

Question 6

Congestive heart failure

Answer 6

the progressive affect of heart failing to properly circulate blood and congestion from fluid retention; MI, high BP and CAD lead to congestive heart failure

Question 7

Raising prevalence of HF due to:

Answer 7

AGING POP (70% admitted are over 50), REVASC AND THROMBOLYTIC THERAPY (leave patients with myocardial damage that can evolve into HF)

Question 8

Frank Starling Mechanism

Answer 8

compensatory mech to preserve CO; cardiac muscle fibres stretch prior to contraction to generate greater force thus creating greater SV (and CO)

Question 9

Ventricular Hypertrophy and Remodeling

Answer 9

compensatory mech to presever CO; increase muscle thickness to pump against high pressure; muscle dilates due to volume overload

Question 10

1. increased afterload

Answer 10

factor the ppt’s HF; causes increased resistance to ejection from ventricle (hypertension, aortic stenosis)

Question 11

2. increased preload

Answer 11

factor that ppt’s HF; increased volume of blood to be pumped (regurgitation)

Question 12

3. Impaired Atrial Emptying

Answer 12

factor that ppt’s HF; AV valves are constricted (MS,TS)

Question 13

4. Impaired Systolic Function

Answer 13

factor that ppt’s HF; reduced myocardial contractility (ischemia, infarction, DSM)

Question 14

5. Increased Metabolic Demand

Answer 14

factor that ppt’s HF; increased demand for blood from periphery (pregnancy, hyperthyroidism, anemia, tachycardia)

Question 15

Stage 1/A of HF

Answer 15

no limitations in physical activity; ordinary activity doesn’t cause fatigue, palpitation, dyspnea, or angina

Question 16

Stage 2/B of HF

Answer 16

Slight limitation of physical activity; comfortable at rest; physical activity results in fatigue, palpitation, dyspnea or angina

Question 17

Stage 3/C of HF

Answer 17

marked limitation of physical activity; comfortable at rest; less than ordinary physical activity results in fatigue, palpitations, dyspnea, and angina

Question 18

Stage 4/D of HF

Answer 18

inability to carry on any physical activity without discomfort; symptoms may be present at rest; any physical activity causes increased discomfort

Question 19

Left heart failure traits

Answer 19

left ventricle isn’t squeezing hard enough; not enough blood getting to periphery (fatigue, decreased pulse and decreased perfusion); will see backup of blood into lungs (crackles, dyspnea)

Question 20

Right heart failure traits

Answer 20

right ventricle isn’t squeezing hard enough; less blood is moving into lungs; will see backup of blood into Right atrium and systemic circulation (JVD, Edema)

Question 21

Congestive Heart Failure

Answer 21

blood isn’t pumping efficiently to body; kidneys sense decreased blood flow causing them to retain more water and Na+, fluid retention causes congestion in tissue which swells/strains the heart