S2 L3.2: Heart Failure (Types, Clinical Manifestations, & Mx)

Question 1

Type of HF where are underlying conditions develop rapidly or an acute precipitating factor is present

Answer 1

Acute HF

Question 2

Duration of Acute HF

Answer 2

1-2 weeks;

then transition into chronic, as long as there are no more hemodynamic adaptations, and they’re stable

Question 3

T/F: Acute HF presents with:
Inadequate organ perfusion or acute congestion of the venous bed draining into the affected atrium

Answer 3

False
Affected ventricle

Question 4

What can be the cause of inadequate organ perfusion?

Answer 4

d/t pump failure

Question 5

When pt becomes very symptomatic
In simple terms, there is sudden crashing of the person’s health status

Answer 5

Sudden Cardiac Decomposition

Question 6

Acute HF:
Statement 1: Sudden reduction in cardiac output
Statement 2: Acute onset of symptoms

a. TF
b. FT
c. TT
d. FF

Answer 6

c. TT

Question 7

This type of HF is when adaptive mechanisms are gradually activated and cardiac hypertrophy develops

Answer 7

Chronic HF

Question 8

Chronic HF
Statment 1: Patient adjust to and tolerates a reduction in cardiac output with more difficulty
Statement 2: If left heart failure develops gradually, the right heart may develop high pressures

a. TF
b. FT
c. TT
d. FF

Answer 8

b. FT
Statement 1: Less difficulty

Question 9

Give 4 Common Precipitating Factors in HF

Answer 9

1. Lack of compliance
2. Uncontrolled HTN
3. Myocardial Ischemia and Infarction
4. Cardiac Arryhythmias
5. Multifocal Atrial Tachycardias
6. Atrial Fibrillation, Flutter
7. Ventricular Tachycardia
8. Fluid Overload
9. Pulmonary Embolism
10. Pulmonary Infection
11. Systemic INfection
12. Endocrine Abnomalities
13. Environmental Factors
14. Inadequate Therapy
15. Emotional Stress
16. Blood Loss, Anemia

Question 10

This type of HF is more often limited to one side when the onset is abrupt where Biventricular failure usually occurs in the long run

Answer 10

Right and Left Sided HF

Question 11

T/F: Left-sided HF follows isolated right-sided HF

Answer 11

False
It rarely follows

Question 12

This type of HF is the typical heart failure that we always talk about where decreased cardiac output and peripheral vasoconstriction is present

Answer 12

Low Output HF

Question 13

This type of HF is when the heart can still eject a normal amount of output (high cardiac output)

Answer 13

High Output HF

Question 14

In High Output HF, how is the heart pumping fast?

Answer 14

D/t metabolic derangement in the periphery (e.g. anemia) or endocrine problems

Question 15

This type of HF is where increased pressure in the system draining into one or both ventricles

Answer 15

Backward HF

Question 16

How can Backward HF result to Pulmonary Htn?

Answer 16

Backwards transmission of pressure (↑ pressure in the LV, LA and pulmonary veins) to the PA

Question 17

This type of HF is when there is inadequate CO in a forward direction

Answer 17

Forward HF

Question 18

Forward HF accounts for many of the clinical manifestations of HF. Name 2.

Answer 18

1. Easily gets dizzy
2. Mental confusion
3. Fatigue and weakness
4. SOdium and water retention

Question 19

This type of HF is your typical pump failure where it is also forward and backwards heart failure. This is caused by chronic contractile dysfunction.

Answer 19

Systolic HF

Question 20

If there is too much pressure/blood in the chamber where there is no space, this can develop into?

Answer 20

Diastolic Dysfunction

Question 21

T/F: HF in CAD patients is often the result of combined systolic and diastolic dysfunction.

Answer 21

True

Question 22

This type of HF pertain to the diastolic phase, however the filling phase does not happen normally, there will be disturbances

Answer 22

Diastolic HF

Question 23

Diastolic HF is primarily due to (3)

Answer 23

1. Reudced ventricular compliance
2. Increased stiffness of the LV
3. Acute reduction in diastolic relaxation during transient ischemia

Question 24

Clinical Types of Heart Failure

a. HF with Reduced Ejection Fraction
b. HF with Midrange Ejection Fraction
c. HF with Preserved Ejection Fraction (HFpEF)

EF = 40-49%

Answer 24

b. HF with Midrange Ejection Fraction

Question 25

Clinical Types of Heart Failure

a. HF with Reduced Ejection Fraction
b. HF with Midrange Ejection Fraction
c. HF with Preserved Ejection Fraction (HFpEF)

EF <40%

Answer 25

a. HF with Reduced Ejection Fraction

Question 26

Clinical Types of Heart Failure

a. HF with Reduced Ejection Fraction
b. HF with Midrange Ejection Fraction
c. HF with Preserved Ejection Fraction (HFpEF)

EF >50%

Answer 26

c. HF with Preserved Ejection Fraction (HFpEF)

Question 27

amount of blood that is ejected by the heart; stroke volume

Answer 27

Ejection Fraction

Question 28

Stages of HF

a. Stage A
b. Stage B
c. Stage C
d. Stage D

With structural heart disease and prior or current symptoms of HF

Answer 28

c. Stage C

Question 29

Stages of HF

a. Stage A
b. Stage B
c. Stage C
d. Stage D

At high risk for HF but without structural heart disease and symptoms of HF

Answer 29

a. Stage A

Question 30

Stages of HF

a. Stage A
b. Stage B
c. Stage C
d. Stage D

Refractory HF

Answer 30

d. Stage D

Question 31

Stages of HF

a. Stage A
b. Stage B
c. Stage C
d. Stage D

With structural heart disease but without signs or symptoms of HF

Answer 31

b. Stage B

Question 32

Stages of HF

a. Stage A
b. Stage B
c. Stage C
d. Stage D

normal individuals, everybody is at risk

Answer 32

a. Stage A

Question 33

Stages of HF

a. Stage A
b. Stage B
c. Stage C
d. Stage D

If pt’s get better, they become asymptomatic c treatment they cannot get out from this stage anymore

Answer 33

c. Stage C

Question 34

Stages of HF

a. Stage A
b. Stage B
c. Stage C
d. Stage D

Worst, even c rest or treatment - Do not move pt’s

Answer 34

d. Stage D

Question 35

Stages of HF

a. Stage A
b. Stage B
c. Stage C
d. Stage D

More prone to develop HF, because structurally, there is already a pathologic change

Answer 35

b. Stage B

Question 36

Name at least 2 Clinical Manifestations of HF

Answer 36

1. SOB
2. PND
3. Orthopnea
4. Fatigue and Weakness
5. Nocturia and Oligura
6. Edema
7. Arrhythmias

Question 37

↑ urine output at night (depends on position)

Answer 37

Nocturia

Question 38

↓ urine output in the morning; When you are upright throughout the day, lesser blood enters the kidneys

Answer 38

Oliguria

Question 39

Happens the the ® side could not handle the pressure coming from the (L) side

Answer 39

Edema

Question 40

d/t dilation of the heart via ↑ of volume and pressure, the electrical conduction system of the heart goes haywire

Answer 40

Arrhythmias

Question 41

Name at least 3 cerebral symptoms

Answer 41

1. Confusion
2. Memory Impairment
3. Anxiety
4. HA
5. Insomnia
6. Nightmares
7. Disorientation
8. Delerium
9. Hallucinations

Question 42

Name at least 2 abdominal symptoms

Answer 42

1. Hepatic congestion
2. ascites
3. easy satiety
4. bloating
5. anorexia
6. vomiting
7. nausea
8. constipation
9. upper abdominal discomfort

Question 43

NYHA Classification (I-IV)

Patients with cardiac disease resulting in slight limitation of physical activity. They are comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain.

Answer 43

II

Question 44

NYHA Classification (I-IV)

Patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary activity fatigue, palpitation, dyspnea, or anginal pain

Answer 44

III

Question 45

NYHA Classification (I-IV)

Patients with cardiac disease but without resulting limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitations, dyspnea, or anginal pain

Answer 45

I

Question 46

NYHA Classification (I-IV)

Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of heart failure or the anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased.

Answer 46

IV