Module 2

Question 1

Heart Failure

Answer 1

• A condition where the heart is not able to pump enough blood for the body’s needs.
• This can be caused by progressive structural and functional changes of the heart.

Question 2

Left HF

Answer 2

• Most common type
• The ability to pump oxygenated blood to the body is compromised.
• Cardiac output becomes insufficient.
• Fluid may back up into the lungs, which is known as pulmonary congestion.

Question 3

Right HF

Answer 3

-Ability to pump deoxygenated blood

Question 4

Hypertrophy

Answer 4

Ventricle wall thickening

Question 5

Dilation

Answer 5

Ventricle wall thining

Question 6

Perserved Heart Failure

Answer 6

• HFpEF (EF >= 50%)
• Also known as diastolic HF
• Ventricle wall thickens
• Myocardium can’t relax properly
• Passive filling may be impaired

Question 7

Reduced Hearth Failure

Answer 7

• HFrEF (EF <= 40%)
• Also known as systolic HF.
• Ventricle wall thins (dilates), so that the ventricles are enlarged.
• Contraction of the myocardium weakens.

Question 8

Normal EF

Answer 8

Between 50%-70%

Question 9

New York Heart Association (NYHA)

Answer 9

Has their own functional classification of HF. (Class 1-4)

Question 10

NYHA Class 1

Answer 10

No limitation of physical activity. Ordinary physical activity doesn’t cause symptoms of HF.

Question 11

NYHA Class 2

Answer 11

Slight limitations of physical activity. Comfortable at rest, but ordinary physical activity results in symptoms of HF.

Question 12

NYHA Class 3

Answer 12

Marked limitation of physical activity. Comfortable at rest, but less than ordinary physical activity results in symptoms in HF.

Question 13

NYHA Class 4

Answer 13

Unable to carry on any physical activity without symptoms of HF, or symptoms of HF at rest.

Question 14

American College of Cardiology Foundation (ACCF)/ American Heart Association (AHA)

Answer 14

Classifies HF based on structural and symptomatic stages of HF.

Question 15

Stage A

Answer 15

High risk for HF but without structural heart disease or symptoms of HF.

Therapeutic Focus:
-modifying risk factors

Question 16

Stage B

Answer 16

Structural heart disease but without signs or symptoms of HF.

Therapeutic Focus:
Treating structural heart disease

Question 17

Stage C

Answer 17

Structural heart disease with prior or current symptoms of HF.

Therapeutic Focus:
-reducing morbidity and mortality

Question 18

Stage D

Answer 18

Refractory HF requiring specialized interventions.

Therapeutic Focus:
-reducing morbidity and mortality.

Question 19

Mortality in HF

Answer 19

• HF is mentioned in 1 of 8 death certificates.

- 50% of patients diagnosed with HF will die within 5 years.

Question 20

Economic Impact

Answer 20

• in 2012, total cost for HF was $30 Billion. With an expected in crease of $69.7 Billion by 2030.

Question 21

Risk Factors

Answer 21

• Conditions that increase the risk of HF.
• Hypertension, diabetes mellitus, metabolic syndrome, atherosclerotic disease.
• Other risk factors include life style (ex: diet), comoborbidities (ex: kidney disease), and genetic.

Question 22

Sympathetic Nervous System (SNS)

Answer 22

• impacts cardiac, vascular, and renal function.
• increases and effects the parasympathetic nervous system.
• If over activation occurs, the blood pressure can increase.

Question 23

Renin Angiotensin Aldosterone System (RAAS)

Answer 23

• Essential for the regulation of blood pressure and fluid balance.
• Stages
  
  1. Renin release
  2. Angiotensin 1
  3. Angiotensin 2 (bad)

Question 24

Angiotensin Converting Enzyme (ACE)

Answer 24

Angiotensin 1 is converted to angiotensin 2 by ACE.

Question 25

Natriuretic Peptides

Answer 25

• Protect cardiac and renal functions and are important diagnostic and prognostic indicators of HF.
• They’re degraded by the enzyme neprilysin.

Question 26

Neprilysin Inhibitors

Answer 26

• Used to treat high blood pressure and HF

- They block neprilysin which will help prevent the breakdown of natriuretic peptides.

Question 27

Signs & Symptoms of HF

Answer 27

Typical :
-Shortness of breath
-Peripheral edema
-Fatigue
Less Typical:
-Coughing
-Confusion
-Loss of appetite and nausea

Question 28

Signs & Symptoms of HF

Answer 28

Typical :
-Shortness of breath
-Peripheral edema
-Fatigue
Less Typical:
-Coughing
-Confusion
-Loss of appetite and nausea

Question 29

Signs & Symptoms of HF

Answer 29

Typical :
-Shortness of breath
-Peripheral edema
-Fatigue
Less Typical:
-Coughing
-Confusion
-Loss of appetite and nausea