Heart failure

Question 1

cardio myopathy

Answer 1

Disease that affects the myocardium – heart muscle

Question 2

causes of cardiomyopathy

Answer 2

Usually idiopathic**
Canby, ischemia, HTN, inherited disorders, infections, toxins, myocarditis, Auto immune

Question 3

Types of cardiomyopathy

Answer 3

dilated
Hyper trophic
Restrictive

Question 4

heart failure

Answer 4

Chronic progressive condition
Heart muscle is unable to pump enough blood to Meet bodies needs for blood and oxygen

Myocardium is weakend, pump is insufficient

Question 5

What is the most common cause of hospitalization?

Answer 5

Heart failure

Question 6

T/F cardiac output, increases with heart failure

Answer 6

False, decreases

Question 7

Preload

Answer 7

Fluid in left ventricle

Question 8

Afterload

Answer 8

Pressure needed for a contraction

Question 9

myocardial contractility

Answer 9

Pump effectiveness

Question 10

which two factors of cardiac output increases with heart failure

Answer 10

Preload and after load

Question 11

which factor decreases with heart failure?

Answer 11

Myocardial contractility

Question 12

pathophys of heart failure

Answer 12

Volume overload – fluid back up, not pumping enough

Impaired ventricular filling

Weakened ventricular muscle

Decrease ventricular contractile function

Question 13

when does the impaired ventricular filling occur?

Answer 13

During diastole in between contractions

Question 14

when does decreased ventricular contractile function occur?

Answer 14

During systole

Question 15

cause of heart failure

Answer 15

Repeated ischemic episodes
MI – papillary muscle rupture
Chronic HTN
COPD
Dysrhythmias
Valve disorders – mitral, insufficiency, aortic stenosis
Pulmonary embolus

Question 16

risk factors for heart failure

Answer 16

1 – HTN
Diabetes
MI within six months - 22% men, 46% women
post menopausal women
African-American
Genetic link, family history
>65
Ischemic, heart disease
Obesity, smoking, sedentary lifestyle
COPD – right sided
Severe anemia
Congenital heart defects
Viruses
Alcohol/drug abuse
Kidney conditions

Question 17

Frank starling law

Answer 17

An increase in resting muscle fiber length results in a greater muscle tension

The heart has the ability to change its force of contraction and stroke, volume in response to changes in venous return

Question 18

left sided heart failure

Answer 18

Congestion and left Chambers and lungs

Left ventricle size increases

Backflow in pulmonary veins

** left=lungs

Question 19

sx left-sided failure

Answer 19

(Pulmonary)
cough, crackles, wheezes
Frothy, sputum, blood tinged
paroxysmal nocturnal dyspnea
Orthopnea

Tachycardia, fatigue, tachypnea, cyanosis, restlessness

Question 20

right sided heart failure

Answer 20

Congestion in right Chambers
Increase in right ventricle size

Backflow into vena cava, decreased to lungs

Congestion in jugular veins, liver, lower extremities

Question 21

sx right sided heart failure

Answer 21

JVD – jugular vein, distention
Dependent edema – below heart
Weight gain
Enlarged spleen and liver

ascites, anorexia, G.I. distress

Question 22

HTN is associated with which side heart failure

Answer 22

Left

Question 23

COPD is associated with which sided heart failure

Answer 23

Right

Question 24

Ejection fraction

Answer 24

amount of blood pumped out of left ventricle with each squeeze

Normal: 55 to 65%

Question 25

reduced ejection fraction/systolic HF

Answer 25

HFreF EF <40% Left ventricle, lose his ability to generate pressure to eject blood Weekend muscle cannot generate stroke, volume and decreased cardiac output Left ventricle fails, blood backs up, fluid back up in pulmonary system

Question 26

Who is HFreF more common in?

Answer 26

Younger age, male History of CAD, DM

Question 27

cause of HFreF

Answer 27

Impaired contractile function Increased afterload Cardiomyopathy Mechanical problems

Question 28

preserved ejection fraction/diastolic HF

Answer 28

HFpeF Inability of ventricles to relax and fell during diastole Left ventricle is stiff and non-compliant leading to high feeling pressures EF is normal or moderate decrease 40-49%

Question 29

what occurs with decreased cardiac output?

Answer 29

Fluid congestion

Question 30

cause of HFpeF

Answer 30

Chronic hypertension

Question 31

Who is HFpeF more common in?

Answer 31

older, female Obese, DM

Question 32

chronic heart failure

Answer 32

Progressive Episodes of decompensated HF New/worst symptoms Frequent ER visits Hospitalization

Question 33

ventricular remodeling

Answer 33

A weakened heart muscle secretes molecular substances Overtime – provoke, genetic changes, apoptosis, hypertrophy of cardiac cells , collagen deposits, and mile cardio fibrosis

Question 34

molecular changes

Answer 34

Angiotensin two, aldosterone, endothelin, TNF alpha, catecholamines, insulin like growth, factor, growth factor enlargement in dilation of left ventricle, worsens heart failure

Question 35

S3 Gallup

Answer 35

Low pitch sound heard after S2 During rapid filling of ventricle, in early part of diastole High ventricular and end-diastolic volume Increased pressure within ventricles

Question 36

T/F greater than 40 years old and presence of S3 is indicative of heart failure

Answer 36

True