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Flashcards in CHF Deck (27):
0

Physiologic complications ofAcute heart failure? May proceed to?

Pulmonary edema and low cardiac output. Cardiogenic shock.

1

Diastolic dysfunction? Caused by?

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

2

Systolic dysfunction? Caused by?

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

3

Cardiac remodeling due to?

Increased cardiac loading (preload and afterload)

4

Congestive heart failure?

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

5

Neuroendocrine responses to CHF?

Activation of RAAS and increased sympathetic activity

6

Symptoms of forward failure?

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

7

Backward failure symptoms?

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

8

Patients with CHF have a high mortality if?

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

9

Death associated with CHF may occur from?

Cardiogenic shock or sudden death from ventricular arrhythmias

10

Chronic pressure overloads that result in CHF?

Aortic stenosis, hypertension

11

Chronic volume overload that result in CHF?

Mitral regurgitation

12

Infiltrative diseases that can result in CHF?

Amyloidosis, hemochromatosis

13

Myocardial injuries that could result in congestive heart failure?

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

14

For patients with heart failure appropriate investigation may include?

Electrocardiography, cardiac stress testing, coronary angiography, biopsy

15

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

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

16

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

ACE inhibitors, Angiotension receptor blockers, beta blockers

17

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

Carvedilol, metoprolol, bisoprolol

18

ACE inhibitors are less effective for CHF in what patients?

Black patients

19

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

Hydralazine with nitrates

20

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

Digoxin

21

Mechanism for beta blockers in CHF?

Prevent and reverse adrenergically mediated intrinsic myocardial dysfunction and remodeling

22

Mechanism of ACE inhibitors in CHF?

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

23

Mechanism of nitrates and nitrates in CHF?

Reduce preload and clear pulmonary congestion

24

Mechanism of action of diuretics in CHF?

Used to decrease preload especially in acute settings

25

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

Ischemic cardiomyopathy due to coronary atherosclerosis

26

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

Ejection fraction less than 40%

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