part 2

Question 1

what is the hallmark of systolic failure?

Answer 1

a decrease in the left ventricular ejection fraction

Question 2

What does systolic failure (HFrEF) mean?

Answer 2

systolic failure heart failure with reduced ejection fraction

Question 3

Explain systolic failure (HFrEF) heart failure with reduced ejection fraction.

Answer 3

• defect in the ventricles ability to pump of contract post MI
• increased after load (HTN), caused by cardiomyopathy or valvular heart disease

Question 4

What does diastolic failure (HRpEF)?

Answer 4

diastolic failure heart failure with preserved ejection fraction

Question 5

explain diastolic failure (HFpEF)

Answer 5

• impaired ability for the ventricles to relax and fill
• decrease in stroke volume and CO
• high filling pressures due to stiff ventricles = venous engorgement

Question 6

When is mixed systolic and diastolic failure seen?

Answer 6

in pt’s with dilated cardiomyopathy

-all bad can’t get enough in or out to the body

Question 7

Early on in heart failure the sympathetic nervous system activates because of inadequate SV or CO. What does the heart put out and what is the result?

Answer 7

• norepinephrine and epinephrine (catecholamines) to increase SV or CO
• this results in increased O2 demand
• the heart can’t handle this demand

Question 8

What does low cardiac output do to the kidneys?

Answer 8

• decreased blood to kidneys
• poor renal perfusion
• RAAS is activated
• kidneys hold onto Na+
• blood volume increases which is too much for the heart

Question 9

What does continuous activation of RAAS cause?

Answer 9

increased levels of ADH

• this causes reabsorption of water
• increases circulating fluid volume
• BP increases (SVR)
• increases preload and after load which the body can’t sustain

Question 10

What re the counter regulatory hormones?

Answer 10

ANP

BNP