Understanding Heart Failure: Key Concepts and Flashcards

Heart Failure 10 studiers today Science Medicine Cardiology Students also viewed Terms in this set (101) Try Magic Notes and save time Upload notes Medical - Covid-19 Teacher 25 terms LearnEnglishStudents Preview PHMY 610 MICRO LAB (10/17) [EXAM … 64 terms gracechristine24 Preview Card 61 te Heart Failure is reduced ______ ability of the heart pumping

when the heart's pumping ability is impacted and reduced, the blood is going to .... causing ...... and eventually .... back up and build up into the lungs causing shortness of breath, dyspnea, and eventually pulmonary edema pinky frothy sputum pulmonary edema Heart Failure is reduction in the efficiency of the heart muscle, through _____ or ____ damage or overloading In a healthy individual, an overloading of blood in the ventricle triggers an_________ to raise the ______ This is called the _____of the heart. in heart failure, this mechanism fails increases in muscle contraction, cardiac output. Frank-Starling law In heart failure, overloading of the ventricles causes a _______ force of contraction because ... reduced force of contraction bc of muscle weakness and reducibility to cross link myosin and actin (the 2 cardiac filaments) in heart failure, why does the heart reduce contraction from the contraction becomes less efficient due to the reducibility to cross link 2 cardiac filaments: actin Flashcards Learn Test Match Q-Ch

in heart failure, stroke volume is reduced why is stroke volume reduced in heart failure failure of systole diastole or both. volume of blood remaining in each ventricle after systole end systolic volume the amount of blood that is in the ventricles before the heart contracts end diastolic volume systolic end volume is increased because of reduced cardiac contractility decrease in diastolic end volume occurs bc there is ____ which occurs when _____ impaired filling of the ventricles which occurs when compliance of ventricles failed or when the walls become thicker Heart Failure is loss of cardiac reserve ability to increase cardiac output during increased activity (ability to work harder during exercise) cardiac reserve

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people with heart failure often use their cardiac reserve... at rest, and mild activity may cause shortness of breath b/c of exceeding their cardiac reserve so the ability to increase their cardiac output fails in a normal person, increased exercise would increase cardiac output but this fails so cardiac output is reduced and cardaic reserve is reduced leading cause of heart failure hypertension other causes of heart failure -acute MI -valve disease -cardiomyopathy -endocarditis left sided heart failure aka congestive heart failure congestion and respiratory left sided heart failure systemic right sided heart failure inadequate contractility systolic dysfunction when there is inadequate contractility from systolic dysfunction, then the the heart cannot eject blood heart is unable to relax and fill with blood diastolic dysfunction

LEFT sided heart failure occurs when the _____ fails, when that fails, ______ fails and blood starts backing up into the ____ and ____ causing a lot of _______ left ventricle fails cardiac output fails left atrium and lungs pulmonary congestion left sided heart failure think LUNGS symptoms of LEFT sided heart failure ⿏ Left think LUNGS!! ⿏ Dyspnea ⿏ Rales/crackles ⿏ Orthopnea ⿏ Weakness and fatigue ⿏ Nocturnal paroxysmal ⿏ Increase HR ⿏ Nagging cough ⿏ Gaining weight Why does left sided heart failure cause dyspnea? In the alveoli of the lungs, all the extra fluid makes oxygen and carbon dioxide exchange a lot harder what will you hear when you auscultate lungs in a pt with left sided heart failure? rales/crackles rales/crackles are heard at bases of lungs bibasilar crackles indicate pulmonary congestion SOB occurring when supine orthopnea

pt has left sided heart failure and is experiencing orthopnea, what will the pt do? sit up to breathe sitting up allows better chest expansion and decrease hypoxia more venous return from the legs and the gut to the heart, which increases the amount of blood backing up into the pulmonary circulation causing orthopnea / nocturnal paroxysmal dyspnea sudden attack of difficult breathing that occurs with during sleep, and then when they sit up it resolves "wakening from a bad dream" nocturnal paroxysmal dyspnea ppl with nocturnal paroxysmal dyspnea often sleep with more pillows to keep upper body elevated, this will allow lower venous return and ease lung congestion in left sided heart failure, the HR increase as a ______ mechanism, in an effort to pick up and transport .... compensatory more oxygen to cells - perfusion. natural response to get fluid out of lungs to improve gas exchange dry, nonproductive cough in left sided heart failure

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capillaries start to burst and end up with blood and fluid that's accumulating in lungs and starts to take on pink frothy appearance bc there's blood in it productive cough - pulmonary edema - left sided heart failure why do people w/ left sided heart failure gain weight? they are in fluid overload in a person with left sided heart failure, gravitational forces cause fluid to sequester in _______ when the person assumes the recumbent position, where does fluid go? lower legs and feet when standing or sitting fluid from leges and dependent parts of body is mobilized and redistributed to an already distended pulmonary circulation and becomes worse bc it can lead to systemic circulation which is right sided heart failure skin of left sided heart failure cool and pale peripheral vasoconstriction extra/abnormal heart sound seen in left sided heart failure s3 s4 a gallop, extra abnormal sound, floppy sort of sound as a result of extra fluid in the ventricles s3

atrial contraction against a non compliant ventricle causing extra heart sound s4 tennesse s4 kentucky s3 restlessness think hypoxia seen in LF HF bc not breathing well, not perfusing well left sided heart failure can cause ______ bluish discoloration of the skin and mucous membranes caused by excess desaturated hemoglobin in the blood cyanosis __ and ____often accompany diminished LV output. Fatigue and weakness In acute or severe left-sided heart failure, CO may fall to levels that are insufficient for providing the brain with adequate oxygen, thus causing confusion and disturbed behavior, mental status changes - think hypoxia

condition of malnutrition and tissue wasting that occurs in people with end-stage heart failure cachexia Might see intercostal spaces when theyre breathing bc everything is sucking into their chest wall cachexia caused by arterial desaturation resulting from impaired pulmonary gas exchange central cyanosis caused by venous desaturation peripheral cyanosis Central cyanosis is best monitored in the lips and mucous membranes bc these areas are not subject to conditions such as cold environment, that cause peripheral cyanosis People with right-sided or left-sided heart failure may develop cyanosis where? around the lips and in the peripheral parts of the extremities. related to loss of atrial contraction, tachycardia, irregular HR, and a drop in blood pressure. atrial fibrillation - most common fibrillation

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People with heart failure are at increased risk for _______, death that occurs within______ sudden cardiac arrest 1 hour of symptom onset. In people with ventricular dysfunction, sudden death is caused most commonly by ventricular tachycardia or ventricular fibrillation. with RIGHT sided heart failure think rest of body: systemic circulation is when right-sided heart failure occurs due to chronic pulmonary disease (COPD) cor pulmonale 2 causes of right sided heart failure pulmonary embolus COPD

right sided heart failure symptoms -fatigue -dependent edema (usually begining at ankles) -pitting edema -edema in sacral area or back of the thighs -right upper quadrant pain -cyanosis of nail beds -increase peripheral venous pressure -ascites -enlarged liver and spleen -may be d degree to chronic pulmonary problems -distended jugular veins -anorexia and complaints of GI distress -swelling in hands and fingers -dependent edema why does ascites happen in right sided heart failure? increase pressure in venous system causes fluid to leak out of vascular space into the abdominal cavity liver can no longer make albumin which is the component of holding fluid in the vascular space so when albumin is low, fluid is going to leak out of vascular space in peritoneal cavity Right-sided heart failure also produces congestion of the . viscera

As venous distention progresses in Right sided HF, blood backs up in the ______that drain into the ______, and the _____ becomes engorged. This may cause _______ and _____ hepatic veins inferior vena cava liver hepatomegaly right upper quadrant pain Portal circulation congestion in right sided heart failure may also lead to spleen engorgement and development of ascites high pressure in lungs is going to lead to right sided heart failure Any disease that causes hypoxia, is going to cause pressure in lungs to go up AKA pulmonary hypertension --> R sided heart failure right ventricular hypertrophy happens with chronic lung disorders or pulmonary embolus how will veins look in right sided heart failure distended JVD manifestations of right sided heart failure -fluid retention and edema -increased capillary pressure -nocturia -oliguria -transudation of fluid: ascites, pleural effusion

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Many of the manifestations of heart failure result from ______that develop in ____ circulation with right-sided heart failure and in the ____ circulation with left-sided heart failure. increased capillary pressures peripheral pulmonary is a nightly increase in urine output that occurs relatively early in the course of heart failure nocturia Increased capillary pressure reflects ______ because of increased _____ and _____ vascular system overfilling sodium and water retention venous congestion (backward failure into left ventricle nocturia occurs because of increased CO, renal blood flow, and glomerular filtration rate that follow the increased blood return to the heart when the person is supine. is a LATE sign related to a severely reduced CO and resultant renal failure oliguria oliguira is urine output less than 400 ml in 24 hours may occur with advanced heart failure Transudation of fluid into the pleural cavity (hydrothorax) or the peritoneal cavity (ascites)

Because pleural veins drain into the systemic and pulmonary venous beds, _____ is common in hypertension involving both venous systems. hydrothorax occurs as excess fluid in the lung interstitial spaces crosses the visceral pleura, which overwhelms the pulmonary lymphatic system. Pleural effusion occurs with increased pressure in the hepatic veins and veins draining the peritoneum. ascites usually reflects right ventricular failure and long- standing elevation of systemic venous pressure in chronic heart failure ascites is secreted by ventricles in response to increased ventricular pressure or fluid overload BNP sensitive indicator of heart failure BNP

the higher the BNP the worse the heart failure >100 what medication do we have to stop 2 hours before drawing BNP nesiritide look at lungs and full of fluid pulmonary infiltrates enlarged heart cardiomegaly chest xray is normal, get a BNP evaluate the pumping ability of heart (ejection fraction) and valvular function echocardiagram normal ejection fraction 55-70% lower the ejection fraction the worse the function of the heart, worse the pumping ability fluid status measured in right atrium CVP increases in right sided heart failure Pressure measured by a catheter in a branch of the pulmonary artery. It is an indirect measure of pressure in the left atrium Pulmonary Capillary Wedge Pressure (PCWP) pulmonary capillary pressure is in direct communication with pressures from the left heart.

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-direct continuous BP measurements -cath inserted into artery -can draw blood and ABG from it -arterial line -pts with acute heart failure when aggresive IV therapy or mechanical device, something implanted in them intra-arterial BP monitoring People who have known heart disease without symptoms during ordinary activity class I People with heart disease who have slight limitations, but not extreme fatigue, palpitations, dyspnea, or angina pain during regular activity class II People with heart disease who are comfortable at rest, but ordinary activity does result in fatigue, palpitations, dyspnea, and angina pain class III

Heart Failure Flashcards | Quizlet

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