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26 Cards in this Set
- Front
- Back
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Manifestation of Systolic Dysfunction in CHF?
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Decreased Stroke Volume
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Manifestations of Diastolic Dysfunction in CHF?
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Decreased Stroke Volume
Increased End-Diastolic Pressure |
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Causes of LV Failure?
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Volume Overload
Pressure Overload Loss of Muscle Loss of Contractility Restricted Filling |
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Types of Volume Overload Etiologies?
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Regurgitant Valves
High Output States:anemia, hyperthyroidism |
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Types of Pressure Overload etiologies?
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HTN
Outflow Obstruction: aortic stenosis, asymmetrical septal hypertrophy |
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Types of Loss of Muscle Etiologies?
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MI
CT disease: SLE |
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Types of Loss of Contractility etiologies?
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Poisons: booze, cobalt, doxorubicin
Infections: viral, bacterial |
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Types of Restricted Filling etiologies?
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Mitral Stenosis
Pericardial Disease: constrictive pericarditis, tamponade Infiltrative Disease: amyloidosis |
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Pathophys changes associated w/ HF?
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Hemodynamic
Neurohormonal Cellular |
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Hemodynamic Changes in HF?
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Dec Output
Dec Filling |
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Neurohormonal Chanes in HF?
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SNS Activation
Renin-Ang activation Vasopressin release Cytokine Release |
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How does the heart compensate for HF?
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Increased Elasticity
Increased Contractile State Increased Preload |
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HF is a syndrome consisting of one or more of the following:
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Dyspnea (esp recumbent)
Lower Extremity Edema Fatigue and dec exercise tolerance Abd Pain w/ or w/o nausea |
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Potential Causes of HF?
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MI's
HTN Viral Infection Valvular Heart Disease Congenital heart Disease Chemo Heavy boozing Others... |
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Compensatory Pathophys Adaptations to CHF?
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LV dilatation
LV hypertrophy Inc SVR secondary to inc SNS activity and inc catecholamines Activation of Renin-Ang system |
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Increased Sympathetic Activity leads to?
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Inc Contractility
Inc HR Inc Preload Inc Afterload Deleterious Cellular Changes |
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Why does Renin-Ang system get kicked started?
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b/c of decrease in renal blood flow
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Bad effects of RAAS?
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Severe Vasoconstriction (inc afterload)
Na and H2O retention (aldo) |
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Other effects of HF?
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Inc Vasopressin-->vasoconstriction
Cytokine Release (myocyte hypertrophy and apoptosis Endothelin (pulm htn) |
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how many new cases of CHF per year?
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500,000
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Most common Sx of HF?
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dyspnea
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what is the hepatojugular reflex and was is it associated w/?
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press on abd (liver)--> jugular distention
= elevated RA pressure |
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Respiratory signs of HF upon auscultation?
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Rales in bases of lungs
Maybe wheezing |
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when are BNP levels indicative of HF?
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>80pg/mL
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What are the NYHA classifications of CV disability?
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4 has sx's at rest
3 has sx's w/ activity 2 has sx's w/ strenuous activity 1 has no sx's |
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Drugs for CHF?
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ACE-I
ARBs BB's Digoxin Diuretics Aldosterone Antagonists |
