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From Flashcardlet > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

Is heart failure a disease?

A

No, it is a syndrome

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2
Q

What happens when body is not able to supply adequate cardiac output to meet the metabolic demands of the body?

A

heart failure

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3
Q

What is 60% of all heart failure due to?

A

CAD

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4
Q

What disorders cause heart failure?

A

disorders that produce primary myocardial damage

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5
Q

What does pressure overload push the body into?

A

volume overload

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6
Q

What causes heart muscle to degenerate?

A

alcohol

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7
Q

Can fluid overload cause heart failure?

A

yes

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8
Q

How does age cause heart failure?

A

loose elasticity

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9
Q

When does HTN cause heart problems?

A

when it is unmanaged

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10
Q

What is cardiomegaly?

A

mega heart - enlarged

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11
Q

What causes Cardiomegaly?

A

unmedically managed HTN for many years

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12
Q

What is it called when myocardial fibers respond with a more forceful contraction when it is stretched?

A

Starling’s law

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13
Q

What does Starling’s law turn into?

A

cardiomegaly

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14
Q

What is volume of blood distending the ventricles at the end of diastole called?

A

preload

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15
Q

What is preload based on?

A

venous return and EF (how full the ventricle is)

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16
Q

What happens to preload if patient is dehydrated?

A

preload is decreased

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17
Q

What happens to preload if patient has fluid overload?

A

preload is increased

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18
Q

What is the amount of tension the ventricle developed during contraction to eject blood from the LV into the aorta?

A

After-load

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19
Q

What is force against which ventricles must work?

A

After-load

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20
Q

What increases force of contraction?

A

Inotrope

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21
Q

What deals with heart rate?

A

Chronotropic

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22
Q

What drug affects inotrope and chronotrope?

A

digoxin

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23
Q

What needs to be done before patient is given digoxin?

A

apical pulse taken

check calcium level

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24
Q

What does dixogin do?

A

decreases HR rate

improves quality of contraction

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25
Q

What is cardiac output?

A

heart rate times stroke volume

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26
Q

What is the amount of blood ejected over a minute?

A

cardiac output

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27
Q

How much blood is normally ejected over a minute?

A

5 liters a minute

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28
Q

What is the normal cardiac output?

A

4-6 liters/min

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29
Q

What is the % of EDV ejected with each ventricular contraction?

A

Ejection Fraction

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30
Q

What is a normal ejection fraction

A

55-70

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31
Q

What is the end of diastolic pressure - volume coming into ventricles?

A

Preload

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32
Q

When is Preload increased?

A

in hypervolemia and regurgitation of cardiac values

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33
Q

What is it called when left ventricle must overcome circulate blood with resistance?

A

Afterload

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34
Q

When is Afterload increased?

A

hypertension

vasoconstriction

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35
Q

What does stoke volume reflect?

A

functionality of heart

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36
Q

What kind of left heart failure cannot contract forcefully enough?

A

Systolic Heart Failure

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37
Q

What left heart failure happens when the left ventricle cannot relax adequately?

A

diastolic heart failure - “stiffened”

38
Q

What happens in left heart failure?

A

heart moves backwards instead of forward so it backs up into pulmonary system

39
Q

What are the s/s of left heart failure?

A 
SOB
cough
crackles
congestion
wheezes
blood tinged sputum
cyanosis
orthopnea
tachycardia
40
Q

What kind of heart failure is more common, left or right?

A

left

41
Q

What is left heart failure?

A

failure of left ventricle to pump blood to the vital organs and peripherally

42
Q

What is left side heart failure usually caused by?

A

MI

43
Q

What is right hear failure usually from?

A

LHF or underlying pulmonary hypertension (CF, emphysema, etc.)

44
Q

What is failure of RH to pump blood into pulmonary vasculature?

A

Right Heart Failure

45
Q

What is high output RHF?

A

cardiac output is normal/above normal but metabolic needs or hyperkinetic state exists

46
Q

What is another name for right heart failure?

A

Cor Pulmonale

47
Q

What is a major sign of Cor Pulmonale?

A

edema - so weigh daily

48
Q

If patient has a cough plus edema, what kind of heart failure do they have?

A

global heart failure - involves both sides

49
Q

this kind of heart failure the tissue demand for O2 exceeds heart’s ability to supply

A

high output

50
Q

What causes high output heart failure?

A 
AV fistula
hyperthyroidism
anemia, sickle cell
Pagets disease of bone
thyrotoxicosis
51
Q

What is low output caused by?

A

decreased pumping ability of myocardium -results in low output

52
Q

What does low output failure occur in?

A

MI
CAD
HTN
Valvular disease

53
Q

If a patient has an MI, what kind of heart failure do they have?

A

low output

54
Q

What are the compensatory mechanisms for LHF?

A

Tachycardia
Ventricular dilation
Ventricular hypertrophy
Renal compensation

55
Q

What causes ventricular dilation in LHF?

A

overstretched - minimized starling’s law

56
Q

What causes Ventricular Hypertrophy in LHF?

A

chronic condition - can only try to manage symptoms

57
Q

What happens when the renal system compensates for LHF?

A

decreased urine

58
Q

What is RHF usually secondary to?

A

LHF

59
Q

Other than LHF, what causes RHF?

A

RV infarction

Cor Pulmonale

60
Q

What do you need to watch for in RHF?

A

distended jugular distention

61
Q

How do you look for distended jugular distention?

A

pt as to be at 45 degree angle

62
Q

What are the s/s of RHF?

A 
fatigue
increase peripheral venous pressure
Ascites
enlarged liver/spleen
distended jugular veins
anorexia
GI distress
swelling of hands/fingers
dependent edema
63
Q

What are the treatment goals for HF?

A

decrease cardiac workload
increase contractility
correct underlying cause
correct fluid overload

64
Q

How do we decrease cardiac workload and increase contractility?

A

digoxin - decrease rate and increase contraction

65
Q

What do you correct for underlying cause?

A

anemia, thyroid issues etc.

66
Q

How do you correct fluid overload?

A

diuretics

67
Q

What should diet be with patients who have HF?

A

low sodium

68
Q

How much urine output do you want patient to have?

A

1cc/min or 60 cc/hr minimum

69
Q

What is accumulation of fluid in the air sacs (alveoli) in the lungs?

A

Pulmonary Edema

70
Q

What are the symptoms of Pulmonary Edema?

A 
Severe dyspnea  
Wheezing 
Coughing
Orthopnea
Cyanosis
*Frothy pink sputum 
*Bubbly respirations
71
Q

What are big indications of pulmonary edema?

A

frothy pink sputum

bubbly respirations

72
Q

What does dyspnea with pulmonary edema cause?

A

O2 to decrease

73
Q

When patient starts wheezing with pulmonary edema, what need to happen?

A

they need to be intubated

74
Q

How does Morphine help Pulmonary Edema?

A

helps anxiety

75
Q

How do Vasodilators help Pulmonary Edema?

A

more oxygenated blood

76
Q

How do diuretics help Pulmonary edema?

A

gets fluid out

77
Q

What position helps patient’s with pulmonary edema?

A

semi to high fowler’s position

78
Q

What helps with dyspnea in pulmonary embolism?

A

Oxygen and or IPPB (intermittent positive pressure)

79
Q

What is given in Pulmonary Edema to decrease resistance in the airway and increasing airflow to the lungs?

A

bronchodilators

80
Q

What is Cardiomyopathy?

A

weakening of the heart muscle

81
Q

What kind of Cardiomyopathy does not have an apex, the muscle is thin and has a global/round shape?

A

Dilated

82
Q

How is Dilated Cardiomyopathy treated?

A

treat symptoms - diuretics - get them on donors list

83
Q

What are the two primary causes of dilated cardiomyopathy?

A

alcohol or viruses

84
Q

What kind of cardiomyopathy has decreased volume and is seen in teens (drop dead on athletic field)?

A

Hypertrophic Cardiomyopathy

85
Q

How is Hypertrophic Cardiomyopathy treated?

A

Calcium channel blockers and Beta Blockers
REST!!
Surgery (myomectomy)

86
Q

What do you NOT need to give patients with Hypertrophic Cardiomyopathy?

A

Diuretics (need volume)
Vasodilators
Inotropics
Digoxin (need increase HR)

87
Q

What kind of Cardiomyopathy is stiffened and there is diastolic failure?

A

restrictive cardiomyopathy

88
Q

What will you hear with Restrictive Cardiomyopathy?

A

S4

89
Q

If patient has fluid overload, what heart sound will you hear?

A

S3

90
Q

If dilated cardiomyopathy is caught early, how is it treated?

A 
O2
fluid restriction
diuretics
inotropic drugs
vasodilators
91
Q

If dilated cardiomyopathy is caught late, what is the only treatment?

A

heart transplant

From Flashcardlet (107 decks)

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