Cardiopulmonary: HF Flashcards
(60 cards)
examples of neurohormonal activation in HF
RAA stimulation
sympathetic stimulation
severity of HF disease is evaluated by
NY Heart Association functional classifications
NYHA classification of heart failure focuses on
activity
ACC/AHA heart failure stages focus on
structural changed
List the classes, I - IV, of NYHA Heart Failure
I-No symptoms c ordinary activity
II-Symptoms c ordinary activity
III-Symptoms c less than ordinary activity
IV-Symptoms at rest
Higher number of letter of class/stage of HF usually means
more drugs used concurrently
Treatment choice for HF is usually based on
Stages/Classes of HF according to NYHA and sometimes ACC/AHA
Compensation derangement: ventricles
ventricular hypertrophy
compensation derangement: neurohormal mechanisms
- adrenergic system
- RAAS
- secretion of ADH and BNP
They go on overdrive and need to be quieted down.
Natriuretic peptides derangements
Normally, these cause you to urinate out sodium. When deranged like in the setting of HF, this may not happen.
Remodeling -> fluid retention -> increased demand
LV becomes floppy, weak, and less effective. Therefore you will have major fluid overload and then derangement of compensation.
Left sided heart failure vs Right sided
Left - lung driven
Right - systemic driven
What is the major cause for symptoms of left sided HF?
Pulmonary congestion
What is the major cause for symptoms of R sided HF?
Systemic venous congestion
High output vs low output HF
less frequent, seen in thyroid disease
demand vs pump function
HFrEF
HF with reduced EF ( <40%)
Systolic
HFpEF
HF with preserved EF (~50%)
Which would you treat more aggressively? Systolic or Diastolic?
Diastolic - in systolic a lot of damage is already done and EF is reduced.
Non pharm tx of HF
lifestyle modification to prevent initial and recurrent injury, progression.
Purpose of pharm intervention for HF
to prevent progression in symptomatic and asymptomatic patients c HF
Digoxin is a
cardiac glycoside
Digoxin is used for its
decreased activation of neurohormonal systems
Digoxin is used more for its _____ properties rather than its ______ property
neurohormonal; positive ionotropic action
Digoxin and mortality
Will increase QoL and reduce symptoms, will not decrease mortality
