Heart Failure

Question 1

cardiac output equation

Answer 1

SVxHR (5L/min)

Question 2

heart failure

Answer 2

progressive disease from a condition that stops adequate cardiac output
risk factors: myocardial ischemia (most common), CAD, hypertension, cardiomyopathy
-involves multiple systems

Question 3

s1 heart sound

Answer 3

mitral and tricuspid valve closing

Question 4

s2 heart sound

Answer 4

aortic and pulmonic valve closing

Question 5

s3 heart sound

Answer 5

ventricular filling during diastole

Question 6

s4 heart sound

Answer 6

BAD

Question 7

systolic dysfunction

Answer 7

less blood ejected/pumped out of the heart during systole (EF<45)
-decreased force, contraction, weakened and enlarged ventricles
-myocardial infarction from decreased contractibility and lost myocytes (heart cells) that don’t regenerate-high mortality

Question 8

diastolic dysfunction

Answer 8

less blood filling during diastole (EF>50)
-CAD, hypertension, stiff and weak ventricles
-normal EF

Question 9

ECHOS

Answer 9

show ejection fractions

Question 10

BNP labs

Answer 10

found in the blood with stretching of arterial walls

Question 11

heart failure manifestations

Answer 11

inadequate supply to brain, forward or backward failure

Question 12

right-sided failure

Answer 12

inadequate RV contractions>systemic congestion since blood isn’t pumped to lungs
-usually from back flow of blood from left heart failure
-can be from infarctions or pulmonary embolism>makes RV pump harder to get blood through, or from pulmonary hypertension>makes RV pump harder from more resistance/after-load
-manifestations: JVD, edema, increased venous pressure, cor pulmonale, GI distress

Question 13

left-sided heart failure

Answer 13

inadequate LV contractions>blood stays in pulmonary circulation and causes pulmonary congestion, edema, and decreased output
-causes: LV MI, hypertension, valve stenosis/insufficiency, nocturnal dyspnea, tachycardia, fatigue, cyanosis/hypoxia
-can cause right-sided heart failure from pulmonary congestion

Question 14

pressures of the left heart

Answer 14

equal forces of COP, hydrostatic pressure
-hydrostatic “push” into the lungs
-COP “pull” fluid back into capillary
-COP pressure is from albumin

Question 15

abnormal pressure of the left heart

Answer 15

decreased hydrostatic pressure/push causes too much fluid in the lung/pulmonary edema
-COP “pull” stays the same so not enough fluid is in the capillaries

Question 16

biventricular heart failure

Answer 16

from LV failure that regresses to the RV
-decreased cardiac output, pulmonary congestion, systemic congestion

Question 17

chronic heart failure

Answer 17

decreased cardiac function from volume overload
-pulmonary and systemic congestion

Question 18

acute heart failure

Answer 18

rapid change in heart failure signs/symptoms
-pulmonary congestion from high LV filling

Question 19

compensation in heart failure

Answer 19

decreased output to renal system>RAAS activation>aldosterone, Na+, H20 retention>increased vascular volume>increased preload>Frank-Starling mechanism (increased force, contraction)
decreased output>sympathetic reflexes activated>increased BP from increased HR and contractility

Question 20

myocardial hypertrophy and remodeling

Answer 20

less affective compensatory mechanism
-from increased work
-remodeling=concentric, symmetric, eccentric

Question 21

HF diagnosis

Answer 21

FACES
-fatigue, activity limitation, congestion, edema, shortness of breath
chest X-ray, ECG, BNP and BNP plasma detection

Question 22

HF classification

Answer 22

classes 1-4:
1-no limitations/symptoms/SD
2-symptoms from activity/small SD
3-some symptoms all around/SD
4-severe symptoms all around/lot of SD

Question 23

HF treatment

Answer 23

ACEIs, aldosterone antagonists, B1 blockers
-diuretics help congestion and workload by reducing VV/preload
-pacemakers
-improvement of risk factors: hypertension, atherosclerosis

Question 24

heart failure in children

Answer 24

usually in infants and from structural (congenital) heart defects
-surgery of heart defects can cause heart failure

Question 25

aging and cardiac function

Answer 25

contributes to HR, doesn’t cause
-hard to diagnose
-increased vascular stiffness, LV hypertrophy