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22 Cards in this Set
- Front
- Back
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Higher mortality rate correlated with
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degree of left ventricular impairment
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Conventional definition of CHF
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failure of the heart as a pump with subsequent inadequate peripheral blood flow to to meet metabolic demands
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Clinical definition of CHF
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syndrome characterized by a decrease in cardiac output and an increase in L Atrial pressure, resulting in dyspnea, fatigue, and decreased exercise tolerance
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Positive therapeutics shift ventricular curves
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L and up
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During CHF, Ventricular function curve shifts
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R and Down
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Classification of CHF:
I |
No symptoms w/ ordinary activity
physical activity not limited |
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Classification of CHF:
II |
Asymptomatic at rest
some symptoms w/ ordinary activity minimal limitation of activity |
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Classification of CHF:
III |
Asymptomatic at rest
symptomatic w/ less that ordinary activity Marked limitation of activity |
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Classification of CHF:
IV |
Symptomatic at rest
activity worsens symptoms |
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Causes of CHF: Pressure overload caused by
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HTN, aortic stenosis, pulmonary HTN
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Causes of CHF: Volume overload caused by
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Aortic/mitral valve insufficiency
congenital defects |
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Causes of CHF: Impaired contractility caused by
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Cardiomyopathy
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Causes of CHF: Cardiac muscle damage caused by
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myocardial ischemia and infarction
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Causes of CHF: Abnormal ventricle filling caused by
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Diastolic dysfunction
Pericardial disease mitral stenosis myocardial fibrosis |
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Causes of CHF:
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Pressure overload
Volume overload impaired contractility Cardiac muscle damage Abnormal Ventricle Filling |
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Factors that precipitate CHF
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Noncompliance
High Na intake Drug therapy with negative inotropic agents arrythmias Stress Pulmonary embolism systemic HTN Infection and inflammation |
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examples of negative inotropic agents
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Antiarrhythmics
Ca channel blockers beta blockers |
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CHF compensatory mechanisms
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Inc SNS activity
Activation of renin-AII system Aldosterone release Cardiac adaptation(dilation, hypertrophy) |
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CHF decompensatory mechanisms
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inc HR
inc SNS(inc BP leads to dec CO, dec CO leads to dec renal perfusion) Inc renin-AII(inc BP, inc edema, inc myocardial hypertrophy) |
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CHF Signs and symptoms:
Right Ventricular Failure |
Pedal/Sacral edema
jugular venous distention hepatojugular reflex hepatomegaly/splenomegaly ascites anorexia (body effects) |
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CHF Signs and symptoms
L Ventricular Falure |
Dyspnea
Orthopnea Pulmonary Edema Pleural Effusion Cough Diaphoresis Paroxysmal nocturnal dyspnea |
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CHF Signs and symptoms
nonspecific |
fatigue
weakness tachycardia nocturia mental status changes |
