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32 Cards in this Set

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

Heart transplant
Hypertrophic Cardiomyopathy
thickened LV
enhanced contracility with obtructed blood flow
unexplained syncope
Tx for hypertrophic cardiomyopathy
BBs and CCBs
Restrictive Cardiomyopathy
impaired diastolic filling with preserved contractility

Cause: Amyloidosis, radiation,sarcoidosis
S/Sx of Restrictive Cardiomyopathy
low volt on ECG with LVH on echo