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10 Cards in this Set

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What are the different types of heart failure
may be on either left or right side, usually biventricular, but is called left or right depending on which is worse

systolic heart failure = ineffective contraction, resulting in low CO and low tissure perfusion

diastolic heart failure = ineffective filling of heart (stiff), low CO and low tissue perfusion
what is most common type of heart failure?
systolic heart failure
How can diastolic and systolic heart failures be diagnosed from eachother?
Ejection fraction

systolic - very low EF

diastolic - normal EF (55-65%)
How is heart failure severity determined?
patient's severity of symptoms

two classification systems:

Class 1-4 - NYHA

Class A-D AHA
Compare the two systems to classify HF
NYHA

Class1 - asymptomatic, no constrain on ADL.
Class2 - slight constrain on ADL. Slight symptoms on activity, but no symptoms on rest.
Class3 - moderate limitation on ADL. Comfortable at rest, but less than ordinart activity causes symptoms.
Class4 - symptoms at rest

AHA

ClassA - high risk for heart disease
ClassB - with heart disease, no symptoms of heart failure
CLassC - with heart disease, current or prior symptoms of HF
ClassD - refractory end stage heart failure
Left sided heart failure clinical manifestiations
Left - pulmonary congestion --> dyspnea, cough, crackles, low oxygen sat, S3. Fluid accumulation in alveoli disrupts oxygen-co2 exchange, resulting in orthopnea and PND. cough initially dry, progressively pink frothy mucus.

Dominant feature: inadequate tissue perfusion --> oliguria --> stim RAAS --> FVE. Decreased workload of heart during sleep improves perfusion, causing nocturia. Anxiety due to dec blood flow to brain
what is oliguria
low urine outoput
Right sided heart failure clinical manifestations
increased venous pressure --> JVD, edema, ascites

--> hepatomegaly and RUQ tenderness ---> inc portal tension --> ascities --> GI/ respiratory distress

venous engorgement of abdominal organs --> anorexia and nausea

reduced CO --< weakness imparied ciurculation
How can you diagnose HF?
symptoms similar to renal failure and COPD, -->

echocardiogrm, CXR, ECG, BNP*
WHat is the key diagnostic factor for HF?
high levels of BNP - indicates high cardiac filling pressure