Hosam Mohamed-
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
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b
Preserved ejection fraction with reduced SV and CO.
a) systolic failure
b) diastolic failure
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65%
What is the normal ejection fraction?
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ischemia, valvular insufficiency, anemia, HTN
Conditions that can result in Systolic failure? (4)
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pericarditis, hypertrophy, aging, ischemia
Conditions that can result in Diastolic failure? (4)
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peripheral edema; pulmonary edema
Right-sided HF results in _______ & Left-Sided HF results in ________.
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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
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a,c
Which conditions cause Peripheral edema?
a) right-sided HF
b) left-sided HF
c) congestitve HF
d) all of the above
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b, c
Which conditions can cause pulmonary edema?
a) right-sided HF
b) left-sided HF
c) congestitve HF
d) all of the above
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congestive HF
-blood flow out of the heart slows and blood returning to the heart backs up
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ability to dispose of sodium/water is compromised; results in increased swelling
How does HF affect the kidneys?
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fatigue, othopnea, rales/restlessness, cyanosis/confusion, extreme weakness, Dyspnea
Signs & Symptoms of Left-Sided HF? (FORCED)
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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)
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preload, afterload, contractility, heart rate
What are the 4 factors of Cardiac Performance?
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decrease preload (SV), loop diuretics/thiazides; venodilators
Treatment goal/medications for issues with Preload?
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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
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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
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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)
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venous circulation
In right-sided HF, blood is backed up into ?
