Emod. Heart Failure

Question 1

4 signs of forward failure?

cause?

Answer 1

Fatigue
Narrow Pulse Pressure
Hypotension
Cool skin

due to reduced perfusion

Question 2

5 signs of backward failure?
cause?
hw do they present?

Answer 2

edema (weight gain)
orthopnea (SOB when supine)
paroxysmal nocturnal dyspnea (breathlessness when waking up
pulmonary rales
audible S3

Congestion

pt presents wet

Question 3

wt happens to MAP in early stages of CHF? why?

Answer 3

MAP is normal due to SNS

Question 4

hw does the SNS become maladaptive in long term CHF?

Angiotensi II?

Answer 4

baroreflex does not reset and chonically activates SNS

ang II- raises set point of HPBR, prevents NE reuptake

Question 5

2 step MOA of edema in HF?

Answer 5

Reduced effective circulating volume (red. perfusion) activates RAAS and SNS

Renal Na retention and edema result

Question 6

wt does ADH do?

wr is it released from?

Answer 6

Regulates osmolarity by increasing water retention in collecting duct
post. pituitary

Question 7

4 tests done when HF is suspected?

Answer 7

ECG
Chest X-ray
BNP lab value

Question 8

first line drug for HF?

Answer 8

ACE inhibitor

Question 9

pt appears wet, cause?

Answer 9

backward failure/congestion

Question 10

pt appears cool, cause?

Answer 10

forward failure/low perfusion