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12 Cards in this Set
- Front
- Back
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What are the S/S of left sided heart failure?
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Extertional dyspnea
Cough Fatigue Orthopnea PND Cardiac enlargement Rales,Gallop rhythm Pulmonary venous congestion |
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What are S/S of Right sided heart failure?
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Elevated venous pressure
Hepatomegaly Dependent edema usu. due to LV failure |
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In pure Right sided heart failure what s/s would not be present?
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Pulmonary edema and congestion. Just would have hepatomegaly and edema.
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With CHF and systolic dysfunction, how are the ventricles affected?
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They are dilated and 'like a floppy rubberband'.
EF decreases to <40-50% from a normal 60%. This can occur secondary to ischemic heart disease. |
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With CHF and diastolic dysfunction, how are the ventricles affected?
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Hypertrophied (thick wall)).
Less volume enters in. EF okay because heart can pump but amount pumped is lower than normal. Caused by - long standing HTN and ischemic HD. |
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First thing to tx with systolic and diastolic dysfunction?
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Decrease preload.
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Stages of CHF?
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High risk for LVD - A
Asymptomatic LVD - B Symptomatic LVD - C Refractory end stage heart failure - D Look at chart |
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What will a CXR show with CHF and pulmonary edema?
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Could be normal - sx may lag up to 6hrs.
Kerly B lines, Cardiomegaly, Increased pulmonary vasculature, Pleural effusion, Interstitial edema |
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Test of choice for CHF and pulm edema?
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Echo -
eval EF, ventricle wall thickness, wall motion, valvular dz(that lead to CHF), syst/diast dysfunction |
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What is BNP?
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Beta or brain naturetic peptide.
Released by increased intracardiac volume. Distinguishes COPD from CHF. <100 r/o CHF >250 rules in CHF |
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Who might BNP be falsely elevated in?
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Elderly, women, liver or renal failure, HRT, PE, Pulm HTN
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How do you tx CHF and pulm edema?
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ABCs, O2, cardiac monitor + pulse ox, IV access, CPAP
Sublingual nitrates - nitroprusside too if BP is stable and nitrates didnt help Diruetics!! Furosemide (Lasix) Bumetadine(Bumex) Morphine - decrease afterload and anxiolytic effect Long term - Lasix, check K+ + ACE, Beta blocker (CAD), Digitoxin(Systolic failure) |
