S2 L3.2: Heart Failure (Types, Clinical Manifestations, & Mx) Flashcards
Type of HF where are underlying conditions develop rapidly or an acute precipitating factor is present
Acute HF
Duration of Acute HF
1-2 weeks;
then transition into chronic, as long as there are no more hemodynamic adaptations, and they’re stable
T/F: Acute HF presents with:
Inadequate organ perfusion or acute congestion of the venous bed draining into the affected atrium
False
Affected ventricle
What can be the cause of inadequate organ perfusion?
d/t pump failure
When pt becomes very symptomatic
In simple terms, there is sudden crashing of the person’s health status
Sudden Cardiac Decomposition
Acute HF:
Statement 1: Sudden reduction in cardiac output
Statement 2: Acute onset of symptoms
a. TF
b. FT
c. TT
d. FF
c. TT
This type of HF is when adaptive mechanisms are gradually activated and cardiac hypertrophy develops
Chronic HF
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
b. FT
Statement 1: Less difficulty
Give 4 Common Precipitating Factors in HF
- Lack of compliance
- Uncontrolled HTN
- Myocardial Ischemia and Infarction
- Cardiac Arryhythmias
- Multifocal Atrial Tachycardias
- Atrial Fibrillation, Flutter
- Ventricular Tachycardia
- Fluid Overload
- Pulmonary Embolism
- Pulmonary Infection
- Systemic INfection
- Endocrine Abnomalities
- Environmental Factors
- Inadequate Therapy
- Emotional Stress
- Blood Loss, Anemia
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
Right and Left Sided HF
T/F: Left-sided HF follows isolated right-sided HF
False
It rarely follows
This type of HF is the typical heart failure that we always talk about where decreased cardiac output and peripheral vasoconstriction is present
Low Output HF
This type of HF is when the heart can still eject a normal amount of output (high cardiac output)
High Output HF
In High Output HF, how is the heart pumping fast?
D/t metabolic derangement in the periphery (e.g. anemia) or endocrine problems
This type of HF is where increased pressure in the system draining into one or both ventricles
Backward HF
How can Backward HF result to Pulmonary Htn?
Backwards transmission of pressure (↑ pressure in the LV, LA and pulmonary veins) to the PA
This type of HF is when there is inadequate CO in a forward direction
Forward HF
Forward HF accounts for many of the clinical manifestations of HF. Name 2.
- Easily gets dizzy
- Mental confusion
- Fatigue and weakness
- SOdium and water retention
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.
Systolic HF
If there is too much pressure/blood in the chamber where there is no space, this can develop into?
Diastolic Dysfunction
T/F: HF in CAD patients is often the result of combined systolic and diastolic dysfunction.
True
This type of HF pertain to the diastolic phase, however the filling phase does not happen normally, there will be disturbances
Diastolic HF
Diastolic HF is primarily due to (3)
- Reudced ventricular compliance
- Increased stiffness of the LV
- Acute reduction in diastolic relaxation during transient ischemia
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%
b. HF with Midrange Ejection Fraction
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%
a. HF with Reduced Ejection Fraction
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%
c. HF with Preserved Ejection Fraction (HFpEF)
amount of blood that is ejected by the heart; stroke volume
Ejection Fraction
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
c. Stage C
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
a. Stage A
Stages of HF
a. Stage A
b. Stage B
c. Stage C
d. Stage D
Refractory HF
d. Stage D
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
b. Stage B
Stages of HF
a. Stage A
b. Stage B
c. Stage C
d. Stage D
normal individuals, everybody is at risk
a. Stage A
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
c. Stage C
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
d. Stage D
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
b. Stage B
Name at least 2 Clinical Manifestations of HF
- SOB
- PND
- Orthopnea
- Fatigue and Weakness
- Nocturia and Oligura
- Edema
- Arrhythmias
↑ urine output at night (depends on position)
Nocturia
↓ urine output in the morning; When you are upright throughout the day, lesser blood enters the kidneys
Oliguria
Happens the the ® side could not handle the pressure coming from the (L) side
Edema
d/t dilation of the heart via ↑ of volume and pressure, the electrical conduction system of the heart goes haywire
Arrhythmias
Name at least 3 cerebral symptoms
- Confusion
- Memory Impairment
- Anxiety
- HA
- Insomnia
- Nightmares
- Disorientation
- Delerium
- Hallucinations
Name at least 2 abdominal symptoms
- Hepatic congestion
- ascites
- easy satiety
- bloating
- anorexia
- vomiting
- nausea
- constipation
- upper abdominal discomfort
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.
II
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
III
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
I
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.
IV
