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13 Cards in this Set
- Front
- Back
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__________ caused by stress from volume stretch in diastole
(due to: inc circulating volume, mitral/aortic insuff, vasoconstriction, atrial kick) |
(inc) Pre-load |
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__________ caused by wall tension needed to overcome resistance to ejection
(due to: aortic stenosis, periph art vasoconstriction, hypertension, polycythemia, arteriolar vasoconstrictor drugs) |
(inc) After-load |
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_________ intrinsic strength & efficiency of myocardial fiber shortening
(due to: hypoxia, hypercapnia, cardiac muscle disease, MI, dec HR, metabolic acidosis) |
(dec) contractility |
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(Right/Left)-sided Heart Failure: -peripheral edema -hepatomegaly -ascites -JVD -fatigue -weakness -anorexia, N/V |
Right-sided heart failure |
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(Right/Left)-sided Heart Failure: *pulmonary -exertional dyspnea -orthopnea -PND -weakness -laterally displace PMI |
Left-sided heart failure (NOT always accompanied by R-failure) |
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What neurohormonal derangements negatively redistribute CO in CHF patietns? |
-inc NE -inc Endothelin -Tumor necrosis factor -natriuretic peptides -Renin-Ang-Ald system |
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High output Heart failure is due to ....... |
excessive demand impaired filling common causes: -thyrotoxicosis -sepsis -anemia -cirrhosis -AV malformations |
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Low output heart failure is due to.... |
poor systolic fxn low ejection fraction common causes: -dilated cardiomyopathy -myocardial ischemia -valvular heart disease -toxins (ETOH) -dysrhthmias |
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CHF treatment steps |
1. get rid of fluid (volume) overload= diuretics 2. oxygen 3. control dysrhythmias 4. reduce preload/afterload 5. remove causative factors |
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After getting rid of excess flud ______ & ____ are used to differentiate btwn stiffened or weakened causes of CHF |
x-ray & echocardiograph |
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If stiffened cardiomyopathy, determine if infiltrative or systemic disease cause (hypertension, DM, etc) & do what? |
treat the underlying cause!! (hypertension, etc) & diuresis |
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If weakened cardiomyopathy, determine if ischemic or if toxins are present & do what? |
treat ischemia & get rid of toxins |
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ABCD hallmarks of CHF therapy |
A- ACE inhibitor B- Beta blockers C- cholesterol-lowering agents D- diuretics (Digoxin + A or B) |
