Module 2 Flashcards
Heart Failure
- A condition where the heart is not able to pump enough blood for the body’s needs.
- This can be caused by progressive structural and functional changes of the heart.
Left HF
- Most common type
- The ability to pump oxygenated blood to the body is compromised.
- Cardiac output becomes insufficient.
- Fluid may back up into the lungs, which is known as pulmonary congestion.
Right HF
-Ability to pump deoxygenated blood
Hypertrophy
Ventricle wall thickening
Dilation
Ventricle wall thining
Perserved Heart Failure
- HFpEF (EF >= 50%)
- Also known as diastolic HF
- Ventricle wall thickens
- Myocardium can’t relax properly
- Passive filling may be impaired
Reduced Hearth Failure
- HFrEF (EF <= 40%)
- Also known as systolic HF.
- Ventricle wall thins (dilates), so that the ventricles are enlarged.
- Contraction of the myocardium weakens.
Normal EF
Between 50%-70%
New York Heart Association (NYHA)
Has their own functional classification of HF. (Class 1-4)
NYHA Class 1
No limitation of physical activity. Ordinary physical activity doesn’t cause symptoms of HF.
NYHA Class 2
Slight limitations of physical activity. Comfortable at rest, but ordinary physical activity results in symptoms of HF.
NYHA Class 3
Marked limitation of physical activity. Comfortable at rest, but less than ordinary physical activity results in symptoms in HF.
NYHA Class 4
Unable to carry on any physical activity without symptoms of HF, or symptoms of HF at rest.
American College of Cardiology Foundation (ACCF)/ American Heart Association (AHA)
Classifies HF based on structural and symptomatic stages of HF.
Stage A
High risk for HF but without structural heart disease or symptoms of HF.
Therapeutic Focus:
-modifying risk factors
Stage B
Structural heart disease but without signs or symptoms of HF.
Therapeutic Focus:
Treating structural heart disease
Stage C
Structural heart disease with prior or current symptoms of HF.
Therapeutic Focus:
-reducing morbidity and mortality
Stage D
Refractory HF requiring specialized interventions.
Therapeutic Focus:
-reducing morbidity and mortality.
Mortality in HF
- HF is mentioned in 1 of 8 death certificates.
- 50% of patients diagnosed with HF will die within 5 years.
Economic Impact
- in 2012, total cost for HF was $30 Billion. With an expected in crease of $69.7 Billion by 2030.
Risk Factors
- Conditions that increase the risk of HF.
- Hypertension, diabetes mellitus, metabolic syndrome, atherosclerotic disease.
- Other risk factors include life style (ex: diet), comoborbidities (ex: kidney disease), and genetic.
Sympathetic Nervous System (SNS)
- impacts cardiac, vascular, and renal function.
- increases and effects the parasympathetic nervous system.
- If over activation occurs, the blood pressure can increase.
Renin Angiotensin Aldosterone System (RAAS)
- Essential for the regulation of blood pressure and fluid balance.
- Stages
- Renin release
- Angiotensin 1
- Angiotensin 2 (bad)
Angiotensin Converting Enzyme (ACE)
Angiotensin 1 is converted to angiotensin 2 by ACE.