Lecture 6 Heart Failure Flashcards

(37 cards)

1
Q

HF is due to impairment of the ability of the heart to _____ _____ or to ____ blood

A

fill with; eject

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2
Q

HFrEF stands for ?

What dysfunction is it due to?

also called ___ HF

A

Heart Failure with reduced Ejection Fraction;

systolic,

Left

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3
Q

What does HFpEF stand for?

What dysfunction is it due to?

also called _____ HF

A

HF with preserved Ejection Fraction;

diastolic;

right

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4
Q

HFrEF is usually caused by ____ with antecedent ____

A

coronary artery disease;

MI

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5
Q

HFpEF is usually seen in what population of people?

A

older women with HTN

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6
Q

Stage A of the new HF classification is defined as:
Stage B = _____
Stage C = _______
Stage D =

A

at risk for CHF;
asymptomatic structural disease (ie previous MI)
previous/current symptoms,
refractory symptoms

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7
Q

what group has the highest risk for HF?

A

blacks

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8
Q

what pulmonary signs are seen in patients with HF?

A

diffuse wet rales/crackles

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9
Q

Where is the PMI displaced in HF?

A

lateral, due to enlarged heart

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10
Q

in HFrEF, there is high _____ venous pressure

A

pulmonary

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11
Q

pulmonary edema is seen as edema located in the ____ on CXR. The _____ ____ vessels in the lung fill up first. This is called ____

A

bases;
super apical;
cephalization

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12
Q

3 special symptoms of L HF

A

orthopnea, paroxysmal nocturnal dyspnea, rales (due to edema)

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13
Q

There may be a ____ ____ and dilated ____ veins due to high hepatic venous pressure in patients with L Hf

A

nutmeg liver;

hepatic

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14
Q

In HF, there is often increased ____ _____ pressure

A

jugular venous (seen as JVD)

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15
Q

Orthopnea and paroxysmal nocturnal dyspnea is due to increased ____ _____ from redistribution of blood

A

increased venous return

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16
Q

3 classic signs of HFpEF (according to FA)

A

hepatomegaly (nutmeg liver), JVD, peripheral pitting edema

17
Q

other symptoms of right sided HF include _____ swelling, _____ gain, fatigue, and ______

A

ankle, weight;

cyanosis/ascites

18
Q

HF:
decreased blood flow to the _____ causes an increase in firing of the _____ ____ Cells. this causes increased produciton of renin

A

kidney;

Juxta-glomerular apparatus

19
Q

In addition to renin activation, decreased cardiac output activates the ____, leading to vaso____, ____ afterload, and ____ contractility

A

Sympathetic NS; constriction, increased, increased

20
Q

combined action of the SNS and renin system leads to an increase in ____ end _____ pressure

A

LV end diastolic

21
Q

A failing heart _____ _____ the frank starling curve due to inabaility to respond to an increased _____

A

falls off;

EDV

22
Q

HF can lead to ______ remodeling, causing dilatation and ____ regurgitation

23
Q

_____ lines are seen on CXR, indicating ____ pulmonary ____

A
kerley B (horizontal);
interstitial pulmonary edema
24
Q

many signs of HF on CXR may be absent in ____ ____ CHF

A

chronic compensated

25
Pressure = _____ * _____ / _____ thus, a big heart is an ______ heart
tension * thickness / radius; ineffecient
26
_____ is generated by cardiomyocytes in the context of numerous triggers, such as myocardial stretch. it ____ in patients with CHF
BNP; | increases (ie greater than 100)
27
_____ can evaluate chamber size, severity of LV or RV dysfunction, valve abnormalities, and more
Echocardiography
28
Equation for ejection fraction: | what is it normally?
(LV EDV - LV ESV) / LV EDV; normally 55-65%
29
_____ training and cardiac _____ are supported by class A evidence in treatment of CHF
exercise; rehabilitation
30
1st line treatment in chronic HF
ACE inhibitors or ARBs
31
Diuretics and digoxin improve _____ but not ___________
symptoms, prognosis
32
other treatments of CHF that improve symptoms and prognosis include ____/isorbide (vasodilator), beta blockers, _____ (Aldosterone antagonist), and implanted devices
hydralazine; | spirinolactone
33
a flat starling curve represents decreased ____ _____ sensitivity patients with HFrEF
LV preload
34
implanted devices include cardiac _____ and an implanted _____ _____
resynchronization; | cardioverter defibrillator
35
_____ and milrinone are used for chronic ionotropic support in patients with severely chronic HF
dobutamine
36
Acute decompensated CHF: 'cold' represents a decreased ______ (aka ________) 'wet' represents an elevated ______
cardiac index (Vasoconstriction/low perfusion) pulmonary capillary wedge pressure (ie edema/congestion)
37
acute CHF treatment: | ____ Reduce fluid volume; vasodilators such as nitroglyerin reduce _____ and ____; and _____ augment contractility
diuretics; preload, afterload; inotropes