heart failure

Question 1

What is the #1 reason for hospitalization of patients age 65 and older?

Answer 1

heart failure

Question 2

What is the definition of heart failure?

Answer 2

Inability of the heart to pump sufficient blood to meet the needs of the tissues for oxygen and nutrients

Question 3

what controls heart rate

Answer 3

Autonomic nervous system (sympathetic and parasympathetic)

Question 4

What are the components of stroke volume?

Answer 4

Preload, afterload, contractility

Question 5

what is preload

Answer 5

Amount of blood in the ventricle at the end of diastole → venous return of blood, compliance of ventricular

Question 6

what is afterload

Answer 6

Amount of resistance to the ejection of blood

Question 7

what is contractility

Answer 7

Percentage of blood volume in the ventricles at the end of diastole that is ejected during systole

Question 8

what is systolic heart failure

Answer 8

Impaired contraction of the heart, low EF, left-sided systolic heart failure

Question 9

what is diastolic heart failure

Answer 9

Impaired filling of the heart stiffened and noncompliant heart muscle, normal EF

Question 10

which heart failure is more common (systolic or diastolic)

Answer 10

systolic

Question 11

what does BNP indicate

Answer 11

how much the chambers stetch

Question 12

what is the most accurate method of identifying chronic heart failure

Answer 12

BNP

Question 13

what does BNP do

Answer 13

reduces systemic blood pressure by reducing afterload

Question 14

what is ventricular remodeling

Answer 14

Heart compensates for the increased workload to increase the thickness of the heart muscle (ventricular hypertrophy)
Enlarged myocardial cells become dysfunctional and die early → leaving the other normal myocardial cells struggling to maintain CO

Question 15

what are the symptoms of left sided heart failure

Answer 15

lung symptoms

Question 16

what are the symptoms of right sided heart failure

Answer 16

the rest of the body

Question 17

what is the ending for ACE inhibitors

Answer 17

Pril

Question 18

what do ACE inhibitors do?

Answer 18

Relieve the s/s of HF and significantly decrease mortality and morbidity of HF

Question 19

What are the side effects of ACE inhibitors?

Answer 19

Angioedema (rare allergic reaction), dry cough, and hyperkalemia

Question 20

What is the ending for ARBs?

Answer 20

Sartan

Question 21

why would an ARB be prescribed

Answer 21

Patient couldn’t tolerate ACE inhibitors

Question 22

what are the side effects of ARBs

Answer 22

Hyperkalemia, hypotension, and renal dysfunction

Question 23

why would a nitrate be prescribed

Answer 23

Patient couldn’t tolerate ACE inhibitors

Question 24

what does nitrate do

Answer 24

venous dilation lowers preload

Question 25

what does hydralazine do

Answer 25

lowers systemic vascular resistance and left ventricular afterload

Question 26

what heart failure medication should be prescribed to a patient with poor kidney function

Answer 26

hydralazine

Question 27

what is the ending for beta blockers

Answer 27

olol

Question 28

what does a beta blocker do

Answer 28

reduces the sympathetic nerve stimlation (lowers HR)

Question 29

what are the side effects of beta blockers

Answer 29

Tired and inability to get it up Patient may feel worse at the beginning

Question 30

how should furosemide be given and why

Answer 30

Very slow push, worried about ototoxicity

Question 31

what diuretic is potassium sparing

Answer 31

spironolactone

Question 32

what are the side effects of diuretics

Answer 32

Electrolyte imbalances, symptomatic hypotension, hyperuricemia (gout), and cardiorenal syndrome

Question 33

what is cardiorenal syndrome

Answer 33

resistance to diuretics

Question 34

what is the most common digitalis

Answer 34

digoxin

Question 35

what is the first sign of digoxin toxicity

Answer 35

vision changes

Question 36

what are the signs of digoxin toxicity

Answer 36

Vision changes, anorexia, nausea, vomiting, fatigue, depression, malaise, changes in heart rate or rhythm; onset of irregular rhythm, sagging ST

Question 37

what should be monitored alongside digoxin and why

Answer 37

Serum potassium, hypokalemia enhances digoxin and could lead to toxicity

Question 38

What is a positive inotrope?

Answer 38

amiodarone

Question 39

what are the benefits of amiodarone

Answer 39

Improved cardiac output, stroke volume

Question 40

what is the risk of amiodarone

Answer 40

Increased myocardial oxygen consumption