when the CO is not enough to perfuse the rest of the body with O2
What is Heart Failure?
a
Reduced contractility and ejection fraction.
a) systolic failure
b) diastolic failure
b
Preserved ejection fraction with reduced SV and CO.
a) systolic failure
b) diastolic failure
65%
What is the normal ejection fraction?
ischemia, valvular insufficiency, anemia, HTN
Conditions that can result in Systolic failure? (4)
pericarditis, hypertrophy, aging, ischemia
Conditions that can result in Diastolic failure? (4)
peripheral edema; pulmonary edema
Right-sided HF results in _______ & Left-Sided HF results in ________.
right-sided HF
-impairs the ability to move deoxygenated blood from systemic to pulmonary circulation
left-sided HF
-impairs the ability to move oxygenated blood from pulmonary to systemic circulation
a,c
Which conditions cause Peripheral edema?
a) right-sided HF
b) left-sided HF
c) congestitve HF
d) all of the above
b, c
Which conditions can cause pulmonary edema?
a) right-sided HF
b) left-sided HF
c) congestitve HF
d) all of the above
congestive HF
-blood flow out of the heart slows and blood returning to the heart backs up
ability to dispose of sodium/water is compromised; results in increased swelling
How does HF affect the kidneys?
fatigue, othopnea, rales/restlessness, cyanosis/confusion, extreme weakness, Dyspnea
Signs & Symptoms of Left-Sided HF? (FORCED)
bloating, anorexia, cyanosis/cool legs, oliguria, nausea, edema, distended neck veins
Signs & Symptoms of Right-Sided HF? (BACONED)
a
No symptoms, but risk factors present.
a) prefailure
b) class I
c) class II/III
d) severe symptoms at rest
b
Symptoms with severe exercise.
a) prefailure
b) class I
c) class II/III
d) severe symptoms at rest
c
Symptoms with mild exercise.
a) prefailure
b) class I
c) class II/III
d) class IV
d
Severe symptoms at rest.
a) prefailure
b) class I
c) class II/III
d) class IV
increased sympathetic/NE, baroreceptor reflex, RAAS, endothelin, ANP/BNP
What are the compensatory mechanisms at play in HF? (5)
preload, afterload, contractility, heart rate
What are the 4 factors of Cardiac Performance?
decrease preload (SV), loop diuretics/thiazides; venodilators
Treatment goal/medications for issues with Preload?
decrease afterload (PR); BBs, ACEi/ARB,
Treatment goal/medications for issues with Afterload?
increase sympathetic outflow and catecholamine release; dobutamine
Treatment goal/medications for issues with Heart rate?
a
At which stage of HF do we treat the primary condition( diabetes, obesity,
HTN, etc.)?
a) prefailure
b) class I
c) class II/III
d) severe symptoms at rest
b
At which stage of HF do we treat symptoms with ACEi/ARB, BB, or diuretic?
a) prefailure
b) class I
c) class II/III
d) severe symptoms at rest
c
At which stage do we add digoxin or an aldosterone antagonist?
a) prefailure
b) class I
c) class II/III
d) severe symptoms at restc
d
At which stage do we do a transplant or implant an LVAD?
a) prefailure
b) class I
c) class II/III
d) severe symptoms at rest
LV, LA, pulmonary circulation
In left-sided HF, blood is backed up into? (3)
venous circulation
In right-sided HF, blood is backed up into ?