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76 Cards in this Set
- Front
- Back
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Cardiac Output |
amount of blood ejected from the heart in liters/min |
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cardiac output equation |
HR x Stroke Volume |
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normal Cardiac Output |
5 to 6 liters/min |
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cardiac index |
cardiac output referenced to body surface area |
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normal cardiac index |
2.5 to 4.0 liters/min |
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Ejection Fraction |
portion of stroke volume ejected per heartbeat |
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EF equation |
end-diastolic volume - end-systolic volume/end-systolic volume |
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normal EF |
50-60% |
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Heart Rate |
first determinate of cardiac output |
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Stroke Volume |
second determinate of cardiac output |
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Stroke Volume |
amount of blood pumped from each ventricular contraction |
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3 factors that determine SV |
preload, after load, contractility |
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Preload |
amount of stretch on cardiac muscles at end of diastole |
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Afterload |
amount of resistance the heart must overcome to pump blood to the body |
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contractility |
ability of the heart muscle fibers to contract |
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Force of contraction |
affects the amount of blood ejected during systole |
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intracardiac and arterial pressure |
2 pressures that affect blood flow |
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Pulmonary Capillary Wedge Pressure |
most important because it reflects ventricular preload |
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systolic pressure |
highest pressure of blood against artery walls |
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diastolic pressure |
lowest pressure of blood against artery walls |
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pulse pressure |
difference between systolic and diastolic blood pressure |
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Factors determining blood flow |
pressure difference, diameter of vessels, volume of blood, resistance, and viscosity |
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distensibility |
ability to expand
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compliance |
elasticity, or distensibility x volume |
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Renin-Angiotensin system |
activated by decreased renal blood flow or increased SNS output |
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causes of HF |
1. increased workload that the heart cannot meet 2. inability of the heart to handle normal workload 3. impaired ventricular relaxation |
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Left-sided |
where HF is most often manifested |
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Left-sided failure |
most often affects the kidneys, but can also affect the brain |
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causes of systolic failure |
1. impaired ability to pump blood 2. excessive afterload |
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diastolic failure |
problem related to filling of ventricles or relaxation of heart during diastole |
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symptoms of HF |
fatigue, shortness of breath, activity intolerance, edema |
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5 year overall survival rate |
50% |
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Heart |
lies in the anterior chest, inferior and left of the sternum |
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atria |
receive blood from the venous circulation |
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ventricles |
pump blood to the body |
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left ventricle |
must pump blood to the entire systemic circulation |
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right ventricle |
must pump blood only to the lungs |
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Left coronary artery |
supplies left ventricle |
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mechanical activity |
described in terms of pressure, volume, and flow changes |
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diastole |
filling of atrium and ventricles |
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systole |
contraction |
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isovolumic contraction |
all valves are closed and the ventricles must generate enough pressure to overcome the pressure in the aorta (left side) |
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afterload |
can be thought of as the amount of vasoconstriction in the arteries |
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approximate % of patients over 75 that have HF |
10% |
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Stage A |
patient at high risk for development of HF but has no apparent structural abnormality of the heart |
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Stage B |
patients have a structural abnormality of the heart but have never had symptoms of HF |
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Stage C |
patients have structural abnormality of the heart and current or previous symptoms of HF |
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Stage D |
patient has end-stage symptoms of HF that are refractory to the standard of treatment |
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NYHA Class I |
no symptoms with normal physical activity (22%) |
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NYHA II |
mild symptoms with normal physical activity (43%) |
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NYHA III |
marked limitation of physical activity (33%) |
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NYHA IV |
symptoms at rest, often bedridden (2%) |
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wet |
dyspnea, cough, edema |
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dry |
dizzy, lightheaded, thirsty, syncope |
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Weber A |
1. >20 <30 mild 2. >14 |
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Weber B |
1. 16-20 mild to moderate 2. 11-14 |
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Weber C |
1. 10-16 moderate to severe 2. 8-11 |
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Weber D |
1. 6-10 severe 2. 5-8 |
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Weber E |
1. <6 very severe 2. <5 |
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T-wave alternans |
potent predictor of SCD |
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T-wave alternans |
every other beat change of T-wave >105bpm |
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S3 |
most common heart sound you get with HF |
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Pulse sound 0 |
non-palpable |
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pulse sound 1 |
weak or thready |
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pulse sound 2+ |
normal |
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pulse sound 3 |
normal |
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pulse sound 4 |
bounding or aneurysmal |
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Nocturia |
a condition in which you wake up during the night because you have to urinate |
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vasopressin |
a hormone that plays a crucial role in limiting the amount of water excreted by the kidneys; secretion of this can lead to fluid retention |
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4 components of ventricular remodeling |
1. ventricular dilatation 2. myocyte hypertrophy 3. interstitial fibrosis 4. apoptosis |
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A-wave |
the velocity flow wave associated with ventricular filling resulting from atrial contraction |
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E-wave |
the velocity flow wave associated with ventricular filling resulting from passive flow blood from the venous system into the ventricle in early diastole
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apoptosis |
premature, programmed cell death |
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aldosterone |
causes fibrosis, ventricular enlargement, and reduced compliance |
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ANP and BNP |
two growth factors important in HF |
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ventricular dilatation |
the ventricular muscle dilates in response to increased volume and pressure |
