Test three b Flashcards
Two types of HF based on cause
Primary causes = underlying cardiac props (CAD, cardiomyopahy)
Precipitating causes = anemia, pulmonary disease, hypervolemia
Others: diabetes, tobacco, obesity, lipids, age
NOT GENETICS
Systolic HF
Pathophysiology: heart has thin walls, so LV can’t pump well
Etiology: impaired contractile function (MI); increased afterload (HTN), cardiomyopathy, or mechanical abnormalities
Diagnosis: decrease in LV EF
Diastolic HF
Pathophysiology: heart has thick walls, so ventricals can’t relax and fill –> decreases SV and CO –> venous engorgement in pulmonary and systemic systems
Etiology: LV hypertrophy from chronic htn, aortic stenosis, or hypertrophic cardiomyopathy
Diagnosis: presence of HF symptoms with normal EF
Mixed HF
Pathophysiology: Poor systolic function is further compromised by dilated LV walls that are unable to relax
Etiology: seen in disease states such as dilated cardiomyopathy
Symptoms: Low systemic BP, low CO, and poor renal perfusion
Compensation: Ventricular dilation, ventricular hypertrophy, activation of SNS and RAAS
Left sided HF
most common
blood backs up into LA and pulmonary veins
pulmonary congestion and edema
Right sided HF
usually caused by LSHF, but not always
blood backs up into RA and venous circulation
peripheral edema, hepatomegaly, JVD
**cor pulmonale can also cause RSHF
Manifestations of HF
Fatigue and anemia
edema
skin changes
behavioral changes
angina
LSHF signs and symptoms
Signs
-LV heaves
-pulsus alternans
-elevated HR
-PMI displaced inferiorly and posteriorly
-crackles
-S3 and S4
-pleural effusion
-mental status changes
-restlessness/confusion
-shallow respirations, dry cough, pink sputum
Symptoms
-dyspnea and orthopnea
-wekaness
-paradoxical nocturnal dyspnea
-nocturia
RSHF signs and symptoms
Signs
-RV heaves
-murmurs
-JVD
-edema
-weight gain
-elevated HR
-ascites
-anasarca
Symptoms
-fatigue
-anxiety/depression
-anorexia and GI bloating
-nausea
-dependent, bilateral edema
-RUQ pain
-hepatomegaly
Clinical manifestations of Acute Decompensated Heart Failure
CAD –> LV failure –> Pulmonary edema where alveoli fill with serosanguineous fluid
-anxiety, pallor, cyanosis, cold/clammy skin
-dyspnea, RR over 30, orthopnea
-coughing with blood tinged sputum
-lung crackles, wheezes, rhonchi
-tachycardia, htn, hpotn,
Etiology of mitral valve stenosis
rheumatic heart disease usually
also:
congenital mitral stenosis
rheumatoid arthritis
systemic lupus erythematosus
mitral valve regurgitation etiology
MI
rheumatic heart disease
mitral valve prolapse
ischemic papillary muscle dysfunction
infective endocarditis
aortic valve stenosis etiology
congenital aortic valve stenosis in kids
in older ppl, its bc of rheumatic fever or degeneration
aortic valve regurgitation etiology
Acute: IE, trauma, aortic dissection
chronic: htn, rheumatic heart disease, congenital bicuspid aortic valve, syphilis, chronic arthritic conditions
results of mitral and aortic stenoses
mitral
-higher pulmonary vascular pressure due to backup
aortic
-left ventricular hypertrophy and increased myocardial oxygen consumption from increased myocardial mass
