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32 Cards in this Set
- Front
- Back
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#1 etiology of HF
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#1 etiology is CAD
has replaced HTN and valvular HD |
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Tx of HF
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ACE-I and Beta-blockers
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Classification of HF
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Class 1: no symptoms
Class 2: symptoms with ordinary activity Class 3: symptoms with less than ordinary activity Class 4: symptoms at rest |
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at what stage of HF do you have structural heart disorder but no signs/symptoms of HF
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Stage B
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these symptomes suggest:
dyspnea, fatigue, rales, tachycardia, cardiomegaly, S3 gallop, edema, etc |
Congestive Heart Failure
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early compensatory responses of CHF
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dilatation and hypertrophy, thus maintaining cardiac output
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Late responses of the body to CHF
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sympathetic(vasoconstriction) and the RAAS response to conserve volume
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consequence of vasoconstriction and RAAS stimulation
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Intravascular circulatory congestion (elevated LVEDP and pulmonary venous pressures)
Movement (“transudation”) of fluid out of intravascular space into interstitial Now problems with pulmonary edema, peripheral edema, hepatomegaly…. |
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what is transudation
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movement of fluid from the lumen of vessels into the interstitial space(peritoneum, legs, etc)
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what happens in regards to the LV with HF pts?
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< Stroke Volume
> End Diastolic Volume (EDV) < Ejection Fraction means the ventricle is more full, ejects less and retains more residual volume |
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why don't you use CCBs with CHF patients?
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because you need the heart to increase contractility since they have < stroke volume, therefore you don't want to block the calcium going in
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which S sound is commonly heard in children and young adults
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S3; In the elderly, it means HF
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actions of Alpha receptors
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vasoconstriction intestinalrelaxation pupillary dilatation
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actions of Beta 1 receptors
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increase in HR/contractility
lipolysis |
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actions of Beta 2 receptors
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vasodilatation
bronchodilation |
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what mechanism increases preload?
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Na+/water retention by the kidneys
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why are BBs used to treat CHF?
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to renew responsiveness to the positive inotropic effects of NE
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With which pts are BBs contraindicated
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with acute CHF patients; only with compensated pts
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What is BNP
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B-type natriuretic peptide; promotess natriuresis; this test should be done if you suspect CHF
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Pharm Tx for CHF
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Diuretics
Vasodilators Inotropics(Digitalis) Neurohormonal manipulation/inhibition Anti-arrhythmics Anticoagulation |
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Drugs for stable CHF pts
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ACE-I
Beta Blockers |
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S/Sx of CHF
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DOE, Orthopnea
Pink Frothy Sputum Peripheral Edema, JVD, Hepatomegaly S3 or S4 Laterally Displaced PMI Pulsus alternans |
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How do you Dx CHF
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BNP
CXR cardiomegaly, pleural effusion/congestion Echo wall motion & EF |
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How do you treat CHF
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Diuretics
thiazides first ACE & B-blockers (don’t use B-blkrs in acute CHF) Decreases mortality Digoxin |
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The 3 types of Cardiomyopathies
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Dilated
Hypertrophic Restrictive |
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MCC of Dilated Cardiomyopathy
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CHF
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S/Sx of dilated cardiomyopathy
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Left Ventricular dilation and dysfunction
High diastolic pressure Low EF |
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Tx of dilated cardiomyopathy
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Manage underlying ds, and CHF
Heart transplant |
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Hypertrophic Cardiomyopathy
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thickened LV
enhanced contracility with obtructed blood flow unexplained syncope |
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Tx for hypertrophic cardiomyopathy
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BBs and CCBs
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Restrictive Cardiomyopathy
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impaired diastolic filling with preserved contractility
Cause: Amyloidosis, radiation,sarcoidosis |
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S/Sx of Restrictive Cardiomyopathy
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low volt on ECG with LVH on echo
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