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29 Cards in this Set
- Front
- Back
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what are the 4 parameters of left ventricular function?
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- contractility
- diastolic function - preload - afterload |
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what is preload?
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the pre-contraction stretch of the myocardium
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what is afterload?
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the resistance to myocardial contraction and left ventricular emptying. this is a function of systemic diastolic blood pressure and resistance
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what is the most common cause of reduced contractility?
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coronary artery disease
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what is the mot common cause of diastolic dysfunction?
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left ventricular hypertrophy
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when do you see abnormal compliance?
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with myocardial ischemia due to coronary artery disease
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when do you see abnormal distensibility?
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usually due to left ventricular hypertrophy
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what is the most common cause of preload disorders?
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mitral valve prolapse
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what is the most common cause of afterload disorders?
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hypertension
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what causes the release of BNP?
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increase in left ventricular wall tension
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what happens to beta-1 adrenergic receptors during left ventricle failure?
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they are down regulated due to excessive stimulation
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what is stage A heart failure?
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the person has risk factors for heart failure
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what is stage B heart failure?
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the person has structural heart disease without symptoms
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what is stage C heart failure?
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the person has structural heart disease with symptoms
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what is stage D heart failure?
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the person is in end stage heart disease
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what is the new york heart association classification system used for?
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to assess activity tolerance
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what is new york heart association class 1?
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patient has no limitations
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what is new york heart association class 2?
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patient has no symptoms at rest but dyspnea with usual activities (moderat exertion)
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what is new york heart association class 3?
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patient has no syptoms at rest but dyspnea with mild exertion
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what is new york heart association class 4?
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patient has symptoms at rest
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where will you see symptoms in a patient with right sided heart failure?
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systemic symptoms such as swelling of the lower extremities
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where will you see symptoms in a patient with left sided heart failure?
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in the lungs
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T or F: in patients with heart failure, we can greatly improve cardiac function by decreasing afterload without decreasing volume.
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false; we get some improvement by only decreasing afterload, but when we also decrease volume we get lots of improvement
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can we improve survival of patients with diastolic heart failure?
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no, nothing improves the survival of these patients
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can we improve the survival of patients with systolic heart failure?
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yes
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what is the definition of systolic heart failure?
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heart failure with an ejection fraction < 40%
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what is the definition of diastolic heart failure?
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heart failure with an ejection fraction >= 40%
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what improves the survival of patients with systolic heart failure?
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- beta blockers
- ACE inhibitors - ARBs - ICDs - cardiac resynchronization therapy |
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what treatments will not improve the survival of patients with systolic heart failure?
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- diuretics
- digoxin - IV inotropes |
