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Flashcards in CHF Deck (27)
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0
Q

Diastolic dysfunction? Caused by?

A

Increased diastolic filling pressure. Caused by impaired diastolic relaxation and decreased ventricular compliance

1
Q

Physiologic complications ofAcute heart failure? May proceed to?

A

Pulmonary edema and low cardiac output. Cardiogenic shock.

2
Q

Systolic dysfunction? Caused by?

A

Low cardiac output (low EF) caused by impaired systolic function

3
Q

Cardiac remodeling due to?

A

Increased cardiac loading (preload and afterload)

4
Q

Congestive heart failure?

A

Heart cannot meet metabolic needs of body but maintains normal ventricular filling pressures

5
Q

Neuroendocrine responses to CHF?

A

Activation of RAAS and increased sympathetic activity

6
Q

Symptoms of forward failure?

A

Forward failure is low cardiac output. Symptoms include fatigue lethargy and hypertension

7
Q

Backward failure symptoms?

A

Backward failure is increased filling pressures or diastolic dysfunction. Symptoms include dyspnea, peripheral edema and ascites

8
Q

Patients with CHF have a high mortality if?

A

Have symptoms at rest, or have an ejection fraction lower than 20%

9
Q

Death associated with CHF may occur from?

A

Cardiogenic shock or sudden death from ventricular arrhythmias

10
Q

Chronic pressure overloads that result in CHF?

A

Aortic stenosis, hypertension

11
Q

Chronic volume overload that result in CHF?

A

Mitral regurgitation

12
Q

Infiltrative diseases that can result in CHF?

A

Amyloidosis, hemochromatosis

13
Q

Myocardial injuries that could result in congestive heart failure?

A

Alcohol, cocaine, ischemic cardiomyopathy, rheumatic fever, viral myocarditis, adriamycin

14
Q

For patients with heart failure appropriate investigation may include?

A

Electrocardiography, cardiac stress testing, coronary angiography, biopsy

15
Q

Heart failure symptoms are usually caused by? Are relieved by?

A

Caused by low cardiac output and fluid overload. Believed with dietary sodium restriction and loop diuretics

16
Q

Drugs that have been shown to reduce mortality in patients with impaired systolic function and moderate to severe symptoms?

A

ACE inhibitors, Angiotension receptor blockers, beta blockers

17
Q

Beta blockers that have been shown to reduce mortality in patients with impaired systolic function?

A

Carvedilol, metoprolol, bisoprolol

18
Q

ACE inhibitors are less effective for CHF in what patients?

A

Black patients

19
Q

In patients who cannot tolerate ACE inhibition use what drugs to lower mortality?

A

Hydralazine with nitrates

20
Q

Drug that can be added to CHF regimens for additional symptom relief but provides no survival benefit?

A

Digoxin

21
Q

Mechanism for beta blockers in CHF?

A

Prevent and reverse adrenergically mediated intrinsic myocardial dysfunction and remodeling

22
Q

Mechanism of ACE inhibitors in CHF?

A

Reduces preload and afterload and prevents remodeling. Drug of choice in CHF because of survival benefit

23
Q

Mechanism of nitrates and nitrates in CHF?

A

Reduce preload and clear pulmonary congestion

24
Q

Mechanism of action of diuretics in CHF?

A

Used to decrease preload especially in acute settings

25
Q

What is the most likely cause of Moderately severe congestive heart failure in a 55-year-old man in the United States?

A

Ischemic cardiomyopathy due to coronary atherosclerosis

26
Q

Determining impaired systolic function as cause of CHF versus impaired diastolic function?

A

Ejection fraction less than 40%

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