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18 Cards in this Set

  • Front
  • Back
Definition of Heart Failure:
Heart Failure Pathology:
2 main types of Heart Failure:
-Diastolic failure: Systolic function is preserved. Is usually due to long standing
hypertension and often is present with LV hypertrophy. Pts. have adequate EF.
Heart Failure Pathophysiology:
Sympathetic activation in Heart Failure:
Renal Factors in Heart Failure:
Aldosterone causes Na retention and increases blood volume (and preload).
Morphological changes in Heart Failure:
Morphological changes depend on the nature of the stresses placed on the heart i.e.. pressure overload leads to
concentric hypertrophy, volume
overload leads to eccentric hypertrophy.
Signs & Symptoms of Heart Failure:
Process of Remodeling is product of 3 factors:
-Loss of myocytes
-Increase in interstitial tissue/fibrotyic process
Issues with preload and hypertrophic left ventricle:
-Too much preload = pulmonary edema
-Not enough preload = decreased CO, can't meet demands
Treatment of Diastolic Heart Failure:
-Diuretics, control HTN (ACE/Beta Blocker), avoid tachycardia, avoid ischemia
4 Stages of Heart Failure according to pathology:
-Stage A: High risk, no s/s
-Stage B: Structural heart disease, no s/s
-Stage C: Structural disease, prior or current s/s
-Stage D: refractory symptoms requiring intervention
New York Heart Association Classification of Heart Failure:
***Classification by functional ability rather than pathology
-Class I: No limitation, ordinary physical exercise does not cause fatigue
-Class II: Slight limitation in physical activity, comfortable at rest but ordinary activity triggers fatigue, palpitations, dyspnea, or angina
-Class III: Marked limitation in physical activity, comfortable at rest but less than ordinary activity triggers fatigue, palpitations, dyspnea, angina
-Class IV: Inability to carry out any physical activity without discomfort, symptoms present even at rest
Non-drug treatment of Heart Failure:
-Biventricular pacing for BBB/conduction disorder
-Mitral Valve Replace
Preciptiating causes of Heart Failure:
Preoperative Care for Heart Failure:
Goals of intraoperative care of Heart Failure:
Intraoperative Care General Anesthesia for Heart Failure:
Emergence/Postoperative Care of Heart Failure:
Heart failure from increased circulating volume is a risk as regional anesthesia
resolves or as 3rd spaced fluid is mobilized (24-72 hrs post op)