Lecture 17: Heart Failure Flashcards Preview

PSIO 485 Exam 04 > Lecture 17: Heart Failure > Flashcards

Flashcards in Lecture 17: Heart Failure Deck (66):
1

What is "Heart Failure?"

- The inability of the CO to keep pace with the body's demands for supplies and removal of wastes
- either one or both ventricles may progressively weaken and fail

2

What is majority cause of heart failure?

Dysfunction of the left ventricle
(systolic and diastolic heart failure)

3

The ____ ventricle also may be dysfunctional especially in ____ disease (_____ _____ failure)

right
pulmonary (right ventricle)

4

What are the Compensatory Measure's first step?

sympathetic activity to the heart is reflexly increased

5

What are the Compensatory Measure's second step?

when CO is reduced, the kidneys, attempt to improve their reduced blood flow, retain extra salt and water in the body during urine formation to expand the blood volume

6

What is Class I?

- No limitation is experienced in any activities
- no symptoms from ordinary activities

7

What is Class II?

- Slight, mild limitations of activity
- the patient is comfortable at rest or with mild exertion

8

What is Class III?

Marked limitation of any activity
the patient is comfortable only at rest

9

What is Class IV?

Any physical activity brings on discomfort and symptoms occur at rest

10

What is Stage A?

- high risk HF in future
- no symptoms at any stage

11

What is Stage B?

- A structural heart disorder
- no symptoms at any stage

12

What is Stage C?

- Previous or current symptoms of HF in the context of underlying structural heart problem
- managed with medical treatment

13

What is Stage D?

- Advanced disease requiring hospital-based support
- heart transplant or palliative care

14

As the disease progresses and the contractility of the heart deteriorates further, the heart reaches a point at which it is no longer able to pump out a normal Stroke Volume despite compensatory measures is called:

Decompensated Heart Failure

15

What is Left Sided Failure?

Backwards failure of the left side leads to pulmonary edema because blood dams up in the lungs

16

Right sided failure has more serious consequences than Left sided failure.
T/F

False, Left side is more serious than right

17

What is "Systolic Left Heart Failure?"

an inability of the heart to generate an adequate CO to perfuse vital tissues

18

Clinical Manifestations
The clinical manifestations of ____ heart failure are the result of ______ ________ congestion and inadequate perfusion of the _______ circulation

right
pulmonary vascular
sympathetic

19

Clinical Manifestations
Individuals experiences:

- Dyspnea
- Orthopnea
- Cough of frothy sputum
- Fatigue
- Decreased Urine output
- Edema

20

Decreasing _____, increasing _____ and _____, as well as blocking the ______ mediators of myocardial toxicity, this will mange systolic left heart failure.

contractility, preload; afterload
neurohumoral

21

These 3 things improve myocardial oxygenation:

- Oxygen
- Nitrates
- Morphine

22

These increase contractility and can help raise the blood pressure in hypotensive individuals:

Intravenous Inotropic drugs

23

These reduce preload:
These reduce both preload and afterload by decreasing aldosterone levels and reducing PVR?

Diuretics
ACE Inhibitors

24

This short acting drug helps reduce mortality:

Intravenous Beta-Blockers

25

This intravenous administration of this to the brain also improves preload and contractility

Natriuretic peptide (Nesirtide)

26

Individuals may benefit from either of these:

Acute Coronary Bypass
Percutaneous Coronary Intervention

27

What is Acute Decompensated Heart Failure (ADHF)?

Worsening signs and symptoms of heart failure

28

what symptoms are associated with ADHF?

Difficulty Breathing
Legs or Feet Swelling
Fatigue

29

What is Acute Heart Failure?

sudden onset of left ventricular failure of an acute primary event

30

The most common precipitating factor of AHF is:

Myocardial Infarction

31

What is Forward Failure? what causes it?

Decreased CO related to Decreased Renal Blood Flow
- It is due to altered glomerular filtration with retention of water and salt

32

What is Backward Failure?

Increased Filling pressure of ventricles due to obstruction
-occurs with mitral or tricuspid stenosis, which causes increased venous pressure with congestion

33

Left sided Heart Failure occurs:

By HBP or CAD

34

What happens to a person with left sided heart failure of the follow?
A) Preload
B) Afterload
C) Contractility

A) Increases
B) Increases
C) Decreases

35

Catecholamine
Prepares body for physical activity
- increases __, __, and ___ ____
- secreted into urine after breaking down and can detect_______

HR, BP, Blood Glucose
Phenochromocytoma

36

Renin-Angiotensin
Regulation of _____ ______ concenctration and arterial ____.

Plasma Sodium
BP

37

Aldosterone
Stimulates ____ secretion, _____ and water reabsorption from the gut

Potassium
Sodium

38

Antidiuretic Hormone
Conserves _____.
AVP is :

water
Arginine Vasopressin

39

Endotoxin are

small, stable, bacterially-derived hydrophobic molecules

40

Cytokines are

signaling molecules that mediate and regulate immunity, inflammation and hematopoiesis

41

Diastolic Heart Failure
this is defined as

pulmonary congestion despite a normal SV and CO

42

Diastolic Heart Failure
Results from decreased ______ of the left ventricle and abnormal ___ ____ such that a normal ____ results in an increased _____

compliance;
diastolic relaxation
LVEDV
LVEDP

43

What treatments would help diastolic failure?

Control BP and HR
Treat symptoms of HF
Reduce symptoms of CAD

44

Right Heart Failure
Results from left ___ ____ when the increase in the left ventricle ___ ____ that is reflected back into the _____ ______ is severe enough

heart failure
filling pressure
pulmonary circulation

45

Right Heart Failure
As pressure in the ____ _____ rises, the ____ to the right ventricular ____ increases

pulmonary circulation, resistance emptying

46

Right Heart Failure
The right ventricle is _____ prepared to compensate for this increased ____ and will ____ and ____.

poorly
workload
dilate and fail

47

Pulmonary Hypertension
Can be caused by a number of factors, all of which forces the heart's ___ ___ to work ____ to pump blood to the ______

right side
harder
lungs

48

Pulmonary Hypertension
The right chamber may ____ as they struggle to function and ___ is often forced ____ through the ______ valve

enlarge
blood
backwards
tricuspid

49

Right Heart Failure
When this happens, ____ will rise in the systemic ____ _____, resulting in ____ ______ and _______

pressure
venous circulation
peripheral Edema
Hepatosplenomeagaly

50

High Output Failure
Is the inability of the heart to

adequately supply the body with blood borne nutrients, despite adequate blood volume and normal or elevated myocardial contractility

51

Common causes of High-output failure are
(Hint: ASHB)

- Anemia
- Septicemia
- Hyperthyroidism
- Beri-Beri

52

Anemia:

- Decreases oxygen carrying capacity to the blood

53

Anemia
____ ____ occurs as the body's cells switch to _____ metabolism

metabolic acidosis
anaerobic

54

Anemia
in response to metabolic acidosis, HR and SV _____ in attempt to circulate blood ____.

increases
faster

55

Anemia
If anemia is ___, maximum CO does not supply the cells with enough ____ for metabolism

severe
oxygen

56

Septicemia
during metabolism, _____ ____ and the ____ process cause systemic _____ and _____.

bacterial toxins; inflammatory
vasodilation; fever

57

Septicemia
In overwhelming septicemia, the ___ may not be able to raise its ____ enough to compensate for ______

heart; output
vasodilation

58

Septicemia
Body tissues show signs of inadequate ___ ___ despite a very high ___ ___

blood supply
cardiac output

59

Hyperthyroidism
This accelerates ___ ____ through the actions of elevated levels of ____ from the thyroid gland. This may occur chronically (_____) or acutely (____ _____)

cellular metabolism
thyroxine
thyrotoxicosis
thyroid storm

60

Beri-Beri
This condition is usually caused by malnutrition of ______ and secondary to chronic _____

thiamine; alcoholism

61

Reversible treatment of CHF include:

Exercise
eating healthy foods
reduction in salty foods
abstinence of smoking and drinking alcohol

62

Drugs that can help with heart failure are:

- Diuretics agents
- Vasodilators agents
- Positive inotropes
- ACE inhibitors
- Beta Blockers
- Aldosterone antagonist

63

Cardiac Resynchronization Therapy may help patients that have:

-Class III or IV
- LVEF of >35%
- QRS interval < 120 ms

64

CRT involves

pacing both left and right ventricles though implantation of a bi-ventricular pacemaker or surgical remodeling of the heart

65

The final option, if all other measure fail is

cardiac transplant or implantation of an artificial heart

66

A new type of surgery invented by a Brazilian doctor in 1994 involves a removal of a ____ of the left ventricle, to make ______ more efficient and prevent ____ of blood into the left atrium through the ______ valve

swath
contractions
backflow
bicuspid