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536 Body Systems > Pathology - Heart Failure/Myopathy > Flashcards

Pathology - Heart Failure/Myopathy Flashcards

(52 cards)

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1
Q

CMD

A

cardiac muscle dysfunction
loss of function or cardiac structure
ex) CHF, heart failure, cardiac conditions, etc - pump fails and heart can’t meet body’s demands

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2
Q

Hypertension - how it causes CMD

A

increased aa. pressure causes ventricular hypertrophy, stretching fibers and decreasing effectiveness of pump

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3
Q

CAD/MI - how it causes CMD

A

ischemia causes dysfunction of ventricles

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4
Q

cardiac arrhythmias - how it causes CMD

A

heart beating out of rhythm can impair ventricle function

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5
Q

renal insufficiency - how it causes CMD

A

acute or chronic, fluid overload due to excess reabsorption of fluid by the kidneys

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6
Q

cardiomyopathy - how it causes CMD

A

impaired contraction/relaxation of myocardium
from pathology or result of systemic disease
primary: genetic/acquired
secondary: infiltrative, storage, toxicity, inflammatory

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7
Q

types of cardiomyopathy

A

dilated
hypertrophic
restrictive
+ primary vs secondary

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8
Q

dilated cardiomyopathy

+ causes

A

enlarged ventricle causes systolic dysfunction
causes: idiopathic, uncontrolled HTN, genetic, inflammatory, toxic, metabolic, pregnancy

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9
Q

hypertrophic cardiomyopathy

A

abnormal L ventricular wall thickness, causes diastolic dysfunction
causes: genetic

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10
Q

restrictive cardiomyopathy

A

abn L ventricular wall stiffness, diastolic dysfunction
causes: infiltrates damaging heart’s ability to relax

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11
Q

primary cardiomyopathy

A

inherited
younger onset
genetic, mixed, or acquired

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12
Q

secondary cardiomyopathy

A

caused by a medical condition

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13
Q

dilated cardiomyopathy s/s

A

symptoms of HF
reduced EF
S3 heart sounds
mitral valve regurgitation
crackles/dullness to percussion
enlarged heart on imaging

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14
Q

hypertrophic cardiomyopathy s/s

A

varying symptoms, presents around age 20
dyspnea
angina
arrhythmia
syncope
S4 heart sound

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15
Q

restrictive cardiomyopathy s/s

A

decreased CO
fatigue
reduced exercise tolerance
systemic edema -> JVD, ascites, peripheral edema
arrhythmias

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16
Q

congenital heart disease - how it causes CMD

A

incompetent/blocked valves makes heart work harder

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17
Q

pulmonary embolism - how it causes CMD

A

increased pulmonary artery pressure increases R ventricle work
treat with rapid fibrinolytic or embolectomy

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18
Q

age related changed - how it causes CMD

A

decreased CO bc of altered contraction/relaxation
higher prevalence of heart disease

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19
Q

HF stages by EF

A

HF w reduced EF (HFrEF) - <40%
HF w mildly reduced EF (HFmrEF) <41-49%
HF w preserved EF (HEpEF) - > 50%
HF w improved EF (HFImpEF) baseline <40% improving

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20
Q

relationship between contractility, CO, EDV

A

increased EDV results in greater contractility
with heart failure contractility decreases, decreasing SV -> CO

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21
Q

3 heart failure etiologies

Study These Flashcards
A

impair cardiac contractility
increase afterload (systolic dysfunction)
impaired ventricular relaxation/filling (diastolic dysfunction)

22
Q

impaired cardiac contractility

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A

reduction in cardiac muscle mass
cardiomyopathy, MI

23
Q

increased afterload

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A

caused by HTN or valve stenosis
these both cause ventricular hypertrophy

24
Q

impaired ventricular relaxation/filling

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A

increased stiffness in ventricle or hypertrophy of the ventricle
MI, mitral/tricuspid valve stenosis, diseased pericardium

25
heart failure etiologies - how does each specific disease cause heart failure? HTN CAD/MI Dysrhythmia Renal Insufficiency Cardiomyopathy Valve abnormality Pericardial effusion Pulmonary Embolism Pulmonary HTN
HTN - increased pressure causes ventricle hypertrophy, pump less effective CAD/MI - damage to L ventricle Dysrhythmia - poor timing impairs ventricle fx/emptying Renal Insufficiency - fluid overload Cardiomyopathy - damaged ventricle Valve abnormality - increase a. P or decrease emptying Pericardial effusion - impaired contraction Pulmonary Embolism - increased work of R ventricle Pulmonary HTN - increased afterload on R ventricle
26
What category of heart failure is HFrEF?
systolic dysfunction L ventricle has reduced capacity to pump blood due to contractility, ventricle stretch, or afterload
27
What category of heart failure is HFpEF?
diastolic dysfunction filling issue due to stiffness of ventricle/hypertrophy
28
S/S of L sided heart failure - diastolic
dyspnea cardiac asthma pulmonary edema frothy cough (hemoptysis) can't breathe when lying down (orthopnea) rales/wheezing, sputum cytology presystolic gallop protodastolic gallop cold extremities oliguria
29
S/S of L sided heart failure - systolic
exercise intolerance fatigue decreased physical/mental performance nocturia rales/wheezing, sputum cytology presystolic gallop protodastolic gallop cold extremities oliguria
30
S/S of R sided heart failure
symptoms: PVD peripheral edema LE edema/bodily swelling nausea/vomiting upper abdominal pain nocturia signs: increased central venous pressure hepatomegaly reflux congestive hepatomegaly ascites proteinuria 4th heart sound
31
findings to both sides of heart failure
tachypnea tachycardia peripheral cyanosis cardiomegaly pleural effusion cachesia (thin)
32
AHA classification of heart failure
Stage A: at risk Stage B: structural heart disease, no symptoms Stage C: clinical heart failure Stage D: refractory heart failure needing advanced intervention
33
compensated heart failure
diagnosed heart failure without symptoms of pulmonary or peripheral congestion stages 1-3 or a-c few symptoms
34
acute uncompensated heart failure
new or worsening symptoms dyspnea, fatigue, edema, weight gain, chest pain, exercise intolerance leads to hospitalization
35
how does decreased CO from HF cause peripheral and pulmonary congestion?
decreased CO causes increased ADH, renin angiotensin, and sympathetic output vasoconstriction increases w circulating volume to increased preload, leading to accumulation in venous system as heart can't keep up with load
36
How is the renal system affected by heart failure?
decreased CO leads to fluid and Na retention, loading the kidneys kidneys are also poorly perfused w O2
37
How does HF affect pulmonary function?
increased fluid in lungs impairing gas exchange
38
How does HF affect liver function?
fluid overload congests hepatic vein poor perfusion of O2 to liver causing cirrhosis
39
How does HF affect skeletal muscle function?
increased weight of limbs poor perfusion atrophy poor exercise tolerance
40
How does HF affect pancreas function?
poor perfusion impaired insulin secretion impaired energy metabolism
41
medical management of HF includes:
lifestyle change - activity, nutrition, smoking/alc/drugs Pharm - diuretics, beta blockers, etc Mechanical - pacemaker, LVAD, etc surgery - repair valves, transplant, CABG dialysis
42
PT exam for HF patient
vitals breathing rate/rhythm orthopnea heart/lung sounds peripheral edema assess exercise tolerance/fxal capacity cognition nutritional status
43
pitting edema scale
0+-4+ 1+ 2 mm depression, doesn't last 2+ 4mm depression, 10-15 s 3+ 6mm depression, 1+ min 4+ 8mm depression, 2+ min
44
Should a HF pt with no SOB, swelling, weight gain, chest pain, or decreased ability in activity continue activity?
Yes!
45
Should a HF pt with mild weight gain, cough, peripheral edema, increased SOB, orthopnea continue therapy?
may need medication adjustment contact physician before continuing
46
Should a HF pt with SOB at rest, unrelieved chest pain, chest tightness at rest, paroxysmal nocturnal dysnpnea/sleeping in chair, 5+ lbs weight gain, and confusion continue therapy?
No, indicates acute decompensation warrants immediate emergency medical attention
47
Specific physiologic benefits of exercise for heart failure
improved exercise tolerance improved coronary a. flow improved quality of life
47
Effect of exercise/rehabilitation on HF patients
does not decrease mortality does improve quality of life and decrease hospitalizations
48
guidelines for rehab for HF pts
low-mod intensity (6-11 RPE) supervised exercise 150 min/wk, 5-7 days a week aerobic>resistive prolonged warm up and cool down monitor vitals HIIT effective for heart remodeling?
49
LIfe's simple 7 + essential 8
modifiable risk factors to reduce risk of heart failure/prevention 1. smoking cessation 2. diet 3. GLC control 4. BMI 5. physical activity 6. BP control 7. decrease cholesterol + 8. sleep
50
Aspects of HF education for patient
adhere to meds explain s/s of exacerbation of HF weight diary for fluid retention diet importance of activity
51
PT recomendations for HF pts
aerobic exercise, resistance exercise, inspiratory muscle training duration: 30-60 min frequency: 3-7 x week aerobic, 2-3 x week other 40-70% aerobic 40-50% resistance HIIT if safe for heart remodeling

536 Body Systems (13 decks)

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