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MAP II Midterm > Heart Failure > Flashcards

Flashcards in Heart Failure Deck (44):
1

What is a complex clinical syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood?

Heart failure

2

What are 3 cardinal manifestations of heart failure?

- dyspnea
- fatigue
- fluid retention

3

Is heart failure preferred over congestive heart failure?

YES

4

What are the 3 clinical manifestations of heart failure?

- marked decrease in exercise tolerance
- decline in functional status
- decrease in quality of life

5

The abnormal stroke volume that comes with heart failure is due to what 3 things?

- impaired contractility
- increased afterload
- impaired ventricular filling

6

What is defined at "tension on muscle fibers at EDV"?

Preload
--> heart cannot contract fully - get increased volume in ventricles

7

Measurements of Heart function?(5)

- ejection fraction
- cardiac output
- LVEDV or LVEDP
- echocardiogram
- exercise stress test

8

What is defined as the resistance encountered by left ventricle when it tries to eject blood (systole)?

afterload

9

afterload increases with what?

increase in arterial vasomotor tone

10

increased afterload causes what?

- increases myocardial oxygen consumption (pumping against resistance)
- decreased stroke volume

11

What are the 3 main types of cardiomyopathy?

- dilated
- restrictive
- hypertrophic

12

Effects of dilated cardiomyopathy?

- muscle fibers have stretched
- heart chambers enlarged

13

Effects of hypertrophic cardiomyopathy?

- growth and arrangement of muscle fibers are abnormal
- heart walls thicken, especially in the left ventricle

14

Effects of restrictive cardiomyopathy?

- ventricle walls stiffen and lose flexiblity

15

What occurs during systolic dysfunction?

- loss of contractility
- dilated ventricle
- increase LVEDV
- lead to decreased EF

16

What occurs during diastolic dysfunction?

- impaired filling due to hypertrophy or decreased filling
- results from hypertension or aortic stenosis

17

What is a sign of cardiac dysfunction?

decreased ejection fraction

18

What is an example of a diagnosis that can lead to heart failure?

cardiomyopathy

19

Three cardinal symptoms of heart failure?

- chronic fatigue
- activity intolerance
- shortness of breath

20

Causes of right sided heart failure?

- increased pulmonary resistance
- increased afterload - pulmonary HTN or valve stenosis
- low preload or poor pump

21

Causes of left sided heart failure?

- impaired contractility
- increased afterload
- loss of myocardial tissue
- low preload

22

Symptoms of right sided heart failure?

- venous congestion
- weight gain
- peripheral edema
- hepatomegaly
- jugular venous distention

23

Symptoms of left sided heart failure?

- dyspnea
- orthopnea
- paroxysmal nocturnal dyspnea
- S3 heart sound
- excessive weight gain
- decreased exercise tolerance

24

What neurohormone maintains normal fluid status and promotes normal cardiac function?

B-type natriuretic peptide

25

What neurohormone is secreted by the left ventricle in response to volume expansion and pressure overload?

B-type natriuretic peptide (BNP)

26

What is the purpose of BNP?

counter regulates renin-angiotensin-aldosterone system by encouraging vasodilation

27

Functional classification of heart failure?

Class I -- no limitation to physical activity
Class II -- Slight limitation of activity - OK at rest
Class III -- OK at rest
Class IV -- Symptoms present at rest

28

Medications that decrease cardiac workload?

- ACE inhibitors -- decrease afterload
- Diuretics -- decrease volume
- Beta-Blockers -- limit SNS stimulation to heart, hold HR down

29

What agent increases cardiac muscle contraction?

Digitalis (glycosides)

30

Cardiac function correlate _____ with the clinical severity of heart failure.

poorly

31

Acute CARDIAC responses to exercise in patients w/ heart failure?

- progressive decrease in CO, SV, and HRR
- limited exercise tolerance

32

Acute CIRCULATORY response to exercise in patients w/ heart failure?

- reduced blood flow
- changed in distribution of blood flow

33

Acute SKELETAL MUSCLE METABOLIC responses to exercise in patients w/ heart failure?

- higher lactate levels at submaximal workloads
- slower on- and off- kinetics w/ exercise

34

Is aerobic interval training or moderate continuous training better for patients w/ heart failure?

aerobic interval training (VO2 peak increased greater)

35

Benefits of exercise in heart failure?

exercise training may reverse peripheral abnormalities
-- autonomic function
-- skeletal muscle blood flow
-- localized oxidative capacity

36

What 3 things does aerobic exercise improve?

- VO2 max
- Dyspnea
- LV function

37

What 3 things does resistance exercise improve?

- LV function
- peak lactate levels
- muscle strength and muscle endurance

38

Do you want aerobic or resistance exercise for HF patients?

BOTH

39

For every 1 MET increase in fitness, what percent reduction do we get in mortality?

10% reduction in mortality

40

4 indications for terminating exercise testing?

- BP
- Angina
- ECG
- Signs

41

What is the equation for RPP?

HR x SBP = RPP

42

What is the best indicator of workload of the heart?

RPP

43

For a patient post-MI, what should their HR be in order to be allowed to exercise?

HR

44

For a patient post-surgery, what should their HR be in order to be allowed to exercise?

30 beats above resting