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24 Cards in this Set
- Front
- Back
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What is the most commonly seen early sign of right CHF, which is not seen in early left CHF?
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JVD
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What are the systolic dysfunctions of CHF? (EF, Preload, LVEDP, contractility)
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Ejection Fraction < 40%
Preload and LVEDP: Inc Contractility: Dec (leads to LV hypertrophy) |
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What causes CHF exacerbation in previously stable patients? (10)
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FAILURE:
Forgot medication; Arrhythmia, Anemia; Ischemia, Infection; Lifestyle (Inc sodium); Upregulation (Inc cardiac output--pregnancy or hyperthyroidism); Renal failure w/ fluid overload; Emboli (pulmonary); Endocarditis |
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What are the diastolic dysfunctions of CHF? (compliance, contraction, recoil, stiffness, LVEDP, CO, EF)
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Compliance: Dec
Contraction: Nml Recoil: Dec Stiffness: Inc LVEDP: Inc CO: Nml EF: Nml to high |
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Which type of CHF dysfunction--systolic or diastolic has a normal ejection fraction and is more common in women?
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dyastolic
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What related heart conditions are seen in the systolic dysfunction of CHF that deals w/ decreased contractility? (4)
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Ischemia (most common);
Dilated Cardiomyopathy; HTN; Valvular dz |
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What related conditions are seen in the systolic dysfunction of CHF that deals w/ Inc afterload? (3)
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Hypertension;
Aortic stenosis; Aortic regurg |
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What related conditions are seen in the diastolic dysfunction of CHF that deals w/ abnormal active relaxation? (2)
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Ischemia;
Hypertrophic cardiomyopathy (from disorders causing LVH) |
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What related conditions are seen in the diastolic dysfunction of CHF that deals w/ abnormal passive filling? (2)
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Restrictive cardiomyopathy;
Concentric hypertrophy from HTN |
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What are the early signs of Left-sided CHF? (2)
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Dyspnea on exertion;
Dec exercise tolerance |
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What are the late sx of Left-sided CHF? (8)
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PORNS DD Tits:
Paroxysmal Nocturnal Dyspnea; Orthopnea; Rales and crackles; Nocturia; S-3 gallop; Diaphoresis; Displaced PMI (laterally); Tachycardia |
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What are the early signs of Right-sided CHF? (6)
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A Juicy CHERry:
Anorexia JVD* Cyanosis Hepatomegaly Edema in periphery RUQ pain |
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What are the late sx of Right-sided CHF? (2)
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abnormal Hepatojugular reflex;
Ascites |
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What force causes the pulmonary congestion in diastolic dysfunction?
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Increased hydrostatic pressure
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what (3) ways can CHF be diagnosed by a CXR?
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Enlargement of cardiac silhouette;
Pulmonary vascular congestion; Kerley-B lines |
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(3) lab methods of diagnosing CHF
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CXR;
Echocardiogram (function of ventricles); Basic Natriuretic Peptide (BNP elevation) |
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AHA staging guidelines for CHF (stages A-D)
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A: at risk but w/o structural heart disorder
B: no sx, w/ structural disorder C: prior or current sx + structure disorder D: end-stage dz |
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NY Heart Assoc Functional Classes of Heart Failure (I-IV)
[measures pt activity limitation] |
I: No limitation
II: slight limitation III: Sx w/ minimal effort, ok at rest IV: Sx at rest |
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SOB while lying flat
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Orthopnea
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What drug classes are good versus CHF? (3)
Which ones are only helpful if patient has a diastolic dysfunction? (2) |
Systolic or Diastolic dysfunction:
ACEIs/ARBs Beta-blockers diuretics Diastolic dysfunction only: Calcium channel blockers Nitroglycerin |
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Name the diuretic used for mild CHF and the 2 for significant CHF
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Mild:
Thiazides Significant CHF: Loop diuretics Spirolactone |
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What is the difference in the signs/sx of people w/ right CHF and cirrhosis? (2)
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Right CHF also has:
1. JVD 2. Orthopnea |
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what are the (5) Tx for Acute Pulmonary Edema and Paroxysmal Nocturnal Dyspnea?
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NOMAD:
Nitroglycerin Oxygen Morphine Aspirin Diuretic |
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What is the rule for prescribing beta-blockers for CHF?
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never give during active CHF--add beta-blockers once the patient is diuresed to dry weight and on stable doses of other medications
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