Heart Failure

Front 1

Heart failure is a failure of the heart to

Back 1

pump effectively to meet the metabolic needs of the body

Front 2

Heart failure mechanism

Back 2

a decrease in pumping ability and a decrease in cardiac reserve combined with the adaptive mechanism used to maintain cardiac output

Front 3

The adaptive mechanisms that contribute to heart failure are

Back 3

1st- sympathetic response then Frank Starling then Myocardial hypertrophic remodeling and natiuretic peptides

Front 4

What does the Frank Starling Mechanism do

Back 4

increases stroke volume by increasing LVEDV and is responsible for activating the Renin-Angiotensin Aldosterone system to increase preload

Front 5

How does the frank sterling mechanism do this

Back 5

increases the SV b/c/ the greater the volume of blood in the heart before contraction, the greater the volume of blood ejected from the heart.
so then Increased contractility (ejaction fraction)occurs from EDV stretch

Front 6

Sympathetic nevous system activity does what

Back 6

releases catecholamines to increase sympathetic tone causing an increase in HR and contractions

Front 7

Myocardial hypertrophy and remodeling does is what

Back 7

the heart hypertrophies to improve work performance (volume in the ventricles are overloaded, the heart gets bigger so the volume decreases)

Front 8

Myocardial hypertrophy can result in

Back 8

changes and function that could result in increased morbidity and mortality over time

Front 9

Natiuretic peptides include what

Back 9

atrial, brain, and C-type natriuretic peptides

Front 10

Atrial natiuretic peptide is released from the atrial cell in response to increases of atrial stretching (holding more volume) and pressure to cause what

Back 10

cause diuresis and block renin-angiotensin mechanism

Front 11

Brain natriuretic peptides are stored in the VENTRICULAR cells and respond when ventricular pressures are increased

Back 11

they do the same, cause diuresis and block RA

Front 12

C-type natuiretic peptides are found in VASCULAR tissue and do what

Back 12

support BP

Front 13

levels of what are elevated in congestive heart failire and why?

Back 13

ANP and BNP b/c ventricular dysfunctions.

Front 14

Congestive heart failure is

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heart failure accompanied by congestion of the bodies tissues.

Front 15

Causes of congestive heart failure are because

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impaired cardiac function, those resulting in excess work demands

Front 16

Etiologies of congestive heart failure associated with impaired cardiac function by decreasing c/o or pumping ability:

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cardiomyopathies, myocarditis and MI's, valvular heart diease either stenotic or regurgitant, congenital defects and constrictive pericarditis.

Front 17

Etiologies of congestive heart failure associated with excess work demands

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increased pressure work by systolic HTN, pulmonary HTN, or coarctation of the aorta (stenosis), those involved with increased volume work: arteriovenous shunts and volume overloads, or those increasing perfusion works: thyrotoxicosis and anemia

Front 18

Systolic vs. Diastolic failure

Back 18

Systolic is a decrease in cardiac contractility and ejection fraction while diastolic has a smaller ventricular chamber size, ventricular hypertrophy, and poor ventricular compliance.

Front 19

RIght sided failure symptoms include

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Congestion of the peripheral tissues (edema), dependent edema and ascites, gi tract congestion (anorexia, gi distress, weight loss), and liver congestion: hepatomegaly and elevated LFT (liver function test)

Front 20

Right sided failure is associated with

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problems with venous return = backflow

Front 21

Left sided failure is a problem with

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pumping blood out to the body

Front 22

Left sided heart failure symptoms are

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decreased CO, activity intolerance, decreased tissue perfusions, pulmonary congestions, signs of hypoxemia (dyspnea, orthopnea, paroxymal nocturnal dyspnea) and pulmonary edema (tachypnea, cough with pink frothy sputum and hypoxemia)

Front 23

Left side shows what symptoms that Right side does not

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pulmonary symptoms

Front 24

Classifying heart failure by two guidelines that are

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NY heart classification (focus' on symptoms) whilte ACC/AHA guidelines (focus on structural defect)

Front 25

NY heart classification

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Class 1- ordinary, no fatigu, dyspnea or angina
Class 2- slight limitation of physical activity with ordinary activity angina, dyspnea, fatigue, but asymptomatic at rest
Class 3- marked limitations of PA but still asymptomatic at rest
Class 4- cant perform PA without symptoms, discomfort increases, and symptoms present at rest

Front 26

ACC/AHA guidelines

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Stage A- at risk for HF but no structural heart disease signs/symptoms
Stage B- structural heart disease but no sign or symptoms
Stage C- structural heart disease with prior/current signs
Stage D- End stage disease needing special treatment such as mechanical support, continuous inotropic therapy and heart transplant