Heart failure Flashcards
Leading causes of systolic heart failure include:
a) CAD and MI
b) HTN
c) Valve disease
d) Alcoholism
e) all of the above
E) All of the above
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“The leading causes of systolic dysfunction include atherosclerotic CAD (including MI), hypertensive heart disease, valvular heard disease, viral myopathies; and toxin exposure such as alcohol, recreational drugs, and chemotherapeutic agents.”
Leading causes of diastolic heart failure include all of the following EXCEPT:
a) inadequate relaxation and loss of muscle fiber elasticity
b) uncontrolled HTN
c) uncontrolled CKD
d) hypothyroidism
C) uncontrolled CKD
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“Diastolic dysfunction results from inadequate relaxation and loss of muscle fiber elasticity, resulting in a slower filling rate and elevated diastolic pressures. Although CO is reduced, EF remains WNL. Potential causes include valvular dysfunction, hypertrophic and ischemic cardiomyopathy, uncontrolled HTN, and hypothyroidism.”
What is “high-output” heart failure?
“High-output HF” is a fairly rare form that takes place when the demands of the body are so great that even increase cardiac output is insufficient. Causative factors include: hyperthyroidism; anemia and arteriovenous shunts.”
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The New York Heart Association classifies Class I HF as…
No limitations. Ordinary physical activity does not cause fatigue, breathlessness, or palpitation (Asymptomatic left-ventricular dysfunction is included in this category)
The American College of Cardiology states Stage A HF is…
Patient at high risk for developing HF but without structural heart disease.
The New York Heart Association classifies Class II HF as…
Slight limitations of physical activity. Comfortable at rest, but ordinary physical activity results in fatigue, palpitation, breathlessness, or angina pectoris (symptomatically “mild” HF).
The American College of Cardiology states Stage B HF is…
Patient with a structural disorder of the heart but who has never developed symptoms of HF.
The New York Heart Association classifies Class III HF as…
Marked limitations of physical activity. Although patient is comfortable at rest, less than ordinary physical activity will lead to symptoms (symptomatically “moderate” HF).
The American College of Cardiology states Stage C HF is…
Patient with past or current symptoms of HF associated with underlying structural disease
The New York Heart Association classifies Class IV HF as…
Inability to carry on any physical activity without discomfort. Symptoms of congestive HF are present even at rest. With any physical activity, increased discomfort is experienced (symptomatically “severe” HF).
The American College of Cardiology states Stage D HF is…
Patient with end-stage disease who requires specialized treatment strategies such as mechanical circulatory support, continuous inotropic infusions, cardiac transplantation, or hospice care.
The main historical pharmaceutical categories used to treat systolic HF include…
Diuretics, ACE inhibitors, ARBs, beta blockers, aldosterone agonists aka mineralocorticoid receptor antagonists and cardiac glycosides.
What do diuretics do in HF?
They reduce preload by decreasing extracellular fluid volume and can be used to decrease HTN that increases afterload.
ACE inhibitors do what in HF?
ACE inhibitors act on the RAAS to decrease preload and afterload. Additionally, they prevent the production of angiotensin II and aldosterone.
What do beta blockers do for HF?
Beta-adrenergic blockers affect the SNS counterregulatory mechanism of HF, decrease ventricular wall tension, decrease apoptosis of the baroreceptors, and prevent down regulation of the beta-2 receptors.
