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Cardiopulmonary Physiology > Cardiac Muscle Dysfunction > Flashcards

Cardiac Muscle Dysfunction Flashcards

(47 cards)

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1
Q

Heart failure definition

A

results from any structural or functional impairment of VENTRICULAR filling or ejection of blood

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2
Q

3 cardinal manifestations of cardiac dysfunction include

A
  • dyspnea
  • fatigue
  • fluid retention
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3
Q

Which term is preferred? Heart failure or congestive heart failure?

A

Heart failure

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4
Q

What is dyspnea?

A

Labored breathing, shortness of breath

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5
Q

What is congestive heart failure?

A

As blood slows out of coming out of the heart it backs up in tissues on it’s return. “Congesting” the aforementioned tissues and resulting in swelling

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6
Q

What are 3 clinical manifestations of heart failure?

A

Marked decrease in exercise tolerance
Decline in functional status
Decrease in quality of life

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7
Q

What can lead to heart failure?

A
  • Excess work loads (HTN, Aortic Stenosis, Pulmonary HTN)
  • Intrinsic Cardiac Diseases
  • Myocardial damage, chemotherapy, radiation, drugs

Family history, chronic alcohol abuse, steroids

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8
Q

What is cardiomyopathy?

A

Heart mucsle is abnormal; loses ability to pump effectively. Heart becomes larger to compensate for weakened condition. —> results in enlarged heart

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9
Q

Abnormal stroke volume can result from

A

Impaired contractillity , increased afterload, and impaired ventricular filling

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10
Q

What is a normal cardiac output amount? In one minute

A

4-8 L a min

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11
Q

What is the normal amount of ejection fraction of the left ventricle? (LVEF)

A

55-75%

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12
Q

What is preload?

A

Tension on muscle fibers at EDV

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13
Q

If that heart cannot contract fully, how does this affect preload?

A

There will be an increase of volume in the ventricles, raising EDV

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14
Q

What is afterload

A

resistance encountered by left ventricle as it attempts to eject blood (systole)

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15
Q

Increase in arterial vasomotor tone leads to what?

A

Afterload

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16
Q

Increased afterload causes what 4 characteristics?

A

increases myocardial oxygen consumption

decreased stroke volume

in normal heart increased afterload has little affect on SV

In heart failure, small increases in afterload can have large impact on stroke volume

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17
Q

3 main types of cardiomyopathy are?

A

Dilated
Restrictive
Hypertrophic

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18
Q

What is dilated cardiomyopathy?

A

Heart is dilated and enlarged and cannot pump blood efficiently

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19
Q

What is restrictive myopathy?

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A

The heart walls are rigid and prevent proper stretching of tissues. Loose flexibility

20
Q

What is hypertrophic myopathy?

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A

Heart muscle is abnormally thick and makes it harder to pump blood. Mostly common in left ventricle.

21
Q

Myopathy dysfunctions that affect systolic pressure affect these 4 things:

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A
  • Loss of contractility
  • Dilated ventricle
  • Increase in LVEDV
  • Lead to decreased ejection fraction
22
Q

Diastolic dysfunction from myopathy affect? Resulting from?

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A

Impaired filling due to hypertrophy or decreased filling

Results from HTN or aortic stenosis/

23
Q

Name 3 causes of right sided heart failure?

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A

Increased pulmonary resistance
Increased afterload
Low preload or poor pump

24
Q

Name 4 causes of left sided heart failure

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A

Impaired contractility
Increased afterload
Low preload
Loss of myocardial tissue

25
What is a common symptom of right heart failure?
Venous congestion!!!
26
Weight gain, peripheral edema, hepatomegaly, jugular venous distention are all symptoms of what side heart failure?
right sided
27
What is pitting edema?
Observable swelling of body tissues due to fluid accumulation that may be demonstrated by applying pressure to the swollen area (such as by depressing the skin with a finger).
28
Dyspnea, orthopnea, nocturnal dyspnea, S3 heart sound and excessive weight gain, decreased tolerance to exercise are signs of what sided heart failure?
Left Heart Failure
29
Pulmonary edema is when pulmonary venous pressure is above ___ mmhg? This leads to a ______ in pulmonary compliance and _____ work of breathing.
> 20mmhg decreased, increased
30
Pulmonary edema often has this type of heart sound, and is common in what side of heart failure?
Crackles, and left heart failure
31
What is the purpose of a compensatory mechanism?
Maintain cardiac output and arterial pressure that can perfuse the brain and heart adequately.
32
The ______ of compensatory adaptations can lead to maladaptive processes leading to end stage HF.
Magnitude
33
Compensatory Mechanisms include: ______ Increase in MAP ______ fluid retention ______ LVEDP ______ stroke volume/ ejection fraction ________ contractility
increase Moderate Increase Decreased Decreased
34
What does decompensated HF refer to?
Deterioration Reduction in exercise tolerance and increasing breathlessness on exertion
35
Compensated heart failure has _____ symptoms. Fluid retention and pulmonary edema are often _____.
stable, absent
36
What is B-type natriuretic peptide BNP?
Endogenous nuerohormone, maintains normal fluid state and promotes normal cardiac function
37
What secretes BNP? | What prompts it's secretion?
Left ventricle in response to volume expansion and pressure overload "myocardial stretch"
38
What is BNP's purpose?
Counter regulation of renin-angiotension-aldosterone system VASODILATION, diuresis, while inhibits renin/angiotension system
39
How many classes of heart failure are there for the New York Heart Association Classification?
4
40
What is class I in the NY Heart association classification?
No limitation of physical activity
41
What is class II in the NY Heart association classification?
Slight limitation of activity. | Example: dyspnea and fatigue with ordinary physical activity
42
What is class III in the NY Heart association classification?
OK at rest | Symptoms of HF with less than ordinary activities.
43
What is class V in the NY Heart association classification?
Symptoms present at rest
44
How does one correct salt and water retention in regards to their preload?
Low sodium diet and diuretics
45
How does one improve contractility of cardiac muscle and it's performance?
Pacemaker, decrease of workload, B-Blockers
46
How does one reduce peripheral resistance as seen in afterload?
Lower BP
47
What 3 drugs are in the HF triple drug cocktail? and why?
ACE inhibitors - decrease afterload Diuretics - decrease volume Beta-Blockers - limit sympathetic stimulation to heart and hold HR down.

Cardiopulmonary Physiology (7 decks)

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