class 11 heart failure Flashcards
cardiac output formula:
heart rate x stroke volume = cardiac output
3 things stroke volume depends on:
1.preload
2.afterload
3.contractility
what is heart failure
a clincial syndrome resulting from structural or functional cardiac disorders that impair the ability of the ventricles to fill or eject blood
heart failure mortality rate
40-50% of patients die within 5 yr of dx
-pt tend to have frequent, long hospital stays
what is ejection fraction
-the volume of blood that the LV ejects out with each contraction
-measured in percentages
what is a normal ejection fraction
50-70% of the ventricle volume
ejection fraction and heart failure
a low EF is a hallmark of HF
-the severity of HF is frequently classified according to the patient’s symptoms
-<40%
heart failure classification I s&s
-no limitations of physical activity
-ordinary activity does not cause undue fatigue , palpatation, or dyspnea
heart failure classification II s&s
-slight limittaion of physical activity
-comfortable at rest, but ordinary physical activity causes fatigue, plapatation, or dyspnea
heart failure classification III s&s
-marked limitation of physical activity
-comfortable at rest, but less than ordinary activity causes fatigue, palpatation, or dyspnea
heart failure classification IV s&s
unable to carry out any physical activity without discomfort
-symptoms of cardiac insufficiency at rest
-if any physical activity is undertaken, discomfort is increased
primary risk factors for HF
-CAD
-hypertension
-valvular disease
contributing risk factors for HF
-diabetes
-tobacco use
-obesity
-high serum cholesterol
manifestations of left sided heart failure
-SOB, dyspnea
-pulmonary edema
-frothy cough, may be blood tinged
-congestion
-fine crackles
-impaired o2 exchange
manifestations of right sided heart failure
-peripheral pitting edema
-weight gain
-ascites
-hepatomegaly
-nausea
-SOB
-usually caused by left HF d/t inc pressure
clinical manifestations of chronic heart failure
-fatigue
-dyspnea, orthopnea, paroxysmal nocturnal dyspnea
-persistent dry cough, unrelieved with position change or OTC cough suppressants
-tachycardia
-dependent edema
-sudden weight gain of >2kg in 2 days may indicate exacerbation of HF
-nocturia
-dusky, cool, damp skin
-skiny swollen legs with dimished/absent hair growth
-restlessness, confusion, decreased memory
-chest pain (angina)
-weight changes
diagnostic test for HF
-echocardiogram
-MUGA scan
-chest x-ray
-EKG
-blood work (CBC, lytes, BUN, creatinine, TSH, BNP (key diagnosic), LFT, urinalysis)