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Flashcards in CHF Deck (55)
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1

What state does CHF result in

Hypervolemic state

2

What is CHF

inability of the heart to pump blood in proportion to metabolic demands
-A disease of aging

3

What is cardiac output of the heart governed by

Preload
After load
Contractile state of myocardium
Heart rate

CO=HRxSV

4

What happens in systolic HF

LV EF reduced

5

What happens in diastolic HF

altered ventricular compliance causes high filling pressures

(EF not affected)

6

What are the causes of Systolic HF

#1: CAD with MI (ischemia in US)
#2: HTN

7

What are the causes of diastolic HF

Abnormal ventricular filling

8

What are causes of LV failure

arrhythmia
valve disease
cardiomyopathy

9

What are causes of RV failure

Left sided HF!

10

What is the ACC/AHA classification

Class A: high risk but no structural abnormality and no symptoms
Class B: Structural abnormality but asymptomatic
Class C: Structural abnormality with HF Symptoms
Claud D: Need intervention due to refractory HF

11

What is the NYHA classification

I: Asymptomatic
II: Symptomatic with moderate exercise
III: Symptomatic with minimal exercise
IIII: Symptomatic at rest

12

What are signs of LV HF

Pulmonary HTN
Pulmonary edema
Crackles
Fatigue
Dyspnea
Elevated JVD
PND

13

What are signs of RV HF

Hepatomegaly
Peripheral edema
Anasarca
Ascites

14

What HF is hepatojugular reflux associated with

Both left and right
(looking for 4cm rise or fall

15

When is S3 seen

With CHF, indicative of fluid sloshing into the dilated ventricles

16

When is S4 seen

In diastolic failure, when the walls are too stiff to allow filling

17

What would you get a CBC to check

Anemia (low H&H), which causes a high output failure

18

What would a CMP reveal

hypo/hyperkalemia
hyponatremia
high BUN/Cr
hight LFT

19

What is BNP

enzyme released from heart in response to ventricular pressure overload

20

What are the important BNP levels

<100: NOT CHF
>400: consistent with CHF

21

What are optimal oxygen sat levels

>92%

22

What ABG's will you see with early CHF

Hypoxia
Hyperventilation
Respiratory ALKalosis

23

What ABG's will you see with critical CHF

Worsening CHF
Metabolic alkalosis

24

What is cardiomegaly

Cardiac silhouette is greater than 1/2 transthoracic diameter

25

What will you see on CXR in CHF

Cardiomegaly
Kerley B Lines
bilateral hilar infiltrates

26

What does a normal size heart with CHF indicate

Mitral stenosis
Constrictive pericarditis
AMI

27

What is the most useful non-invasive diagnostic tool for CHF

Echo
Evaluates Etiology and Extent of HF

28

What does a cardiac cath provide

Direct measurement of ventricular diastolic pressure
(can show impaired relaxation and filling)

29

What does "optimal therapy" require

Combo of:
Multiple meds
TLC
Surgical therapies

30

What vaccines should HF patients receive

Flu
Pneumococcal