20

Question 1

Congestive Heart Failure -
High versus Low -
Systolic versus Diastolic -
Right side versus Left side -

Answer 1

impaired pumping ability
High versus Low - excess need vs impaired output
Systolic versus Diastolic - decreased contractility vs impaired filling
Right side versus Left side - right ventricle impaired vs left
Where is the problem come from

Question 2

Adaptive/ Compensatory Mechanisms,
Compensatory Mechanisms-body tries to fix itself

• Frank-Starling
• Renin-angiotensin
• Myocardial hypertrophy

Answer 2

Frank-Starling-ADH vasoconstriction increase sodium Quantity SNS Activity
Renin-angiotensin - aldosterone Myocardial hypertrophy- chamberget small get less blood

Question 3

Manifestations of Failure

Fluid and edema

Respiratory

Cyanosis

Answer 3

Fluid and edema
       peripheral 
       pulmonary congestion - left failure
Respiratory - nocturnal - left
    Fatigue
    Cachexia
Cyanosis - desaturated hemoglobin
  central - deoxygenated ARTERIAL blood
  peripheral - altered delivery of oxygen
Arrythmias and sudden death

Question 4

Acute Heart Failure Syndromes

Worsening of ……. but responds to ……..

Answer 4

Worsening of function but responds to treatment
New onset acute heart failure
Worsening of end stage heart failure
Acute pulmonary edema

Question 5

Acute Pulmonary Edema

Answer 5

life threatening
most dramatic accumulation of fluid in lungs
sx - gasps when sit at rest, apprehensive

Question 6

Heart transplantation

Answer 6

immunosuppressive therapy required

donor availability and complications

Question 7

Cardiogenic Shock

Answer 7

Pump Failure - sudden, pronounced

Causes – MI, arrhythmias, aneurysm, complications of open heart surgery

Question 8

Circulatory shock - critical decrease in tissue perfusion caused by loss of fluid

Answer 8

`Hypovolemic
`obstructive
`Distributive or vasodilatory
  -neurogenic
  -anaphylactic
  -septic

Question 9

Hyovolemic Shock

Answer 9

Decreased volume - 15-20%

Question 10

Obstructive shock
Mechanical
aneurysm

Answer 10

Mechanical obstruction of blood flow

Aortic aneurysm rupture (dissection)

Question 11

Shock Complications

Answer 11

ARDS
Renal Failure
GI
DIC- consume all platlets
MODS

Question 12

Special Populations

Infants and Children

Answer 12

Infants and Children - congenital defects
The Elderly - 75% of CHF are in people > 65
decreased response to heart stimulation
increased vascular stiffness
heart less compliant
altered cardiac metabolism

Question 13

review

Answer 13

kims prentation