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35 Cards in this Set
- Front
- Back
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DEFINITION
- define CHF |
- Complex clinical syndrome that can result from any
Structural or Functional Cardiac disorder that impairs the ability of ventricles to Fill with or Eject Blood |
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DEFINITION
- The epidemics of CV diseases that are emerging are? x2 |
- Heart Failure
- Atrial Fibrillation |
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DEFINITION
- Is Heart Failure prevalence increasing or decreasing? - why? x2 |
- Increasing
- increase in the Aging population - Prolongation of the lives of Cardiac patients |
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DEFINITION
- Improvements in therapy has done what to the mortality rate of CHF? |
- mortality rate remains unacceptably high
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DEFINITION
-In the US, what population group is seeing an epidemic increase in mortality with CHF? |
- people over the age of 65
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DEFINITION
- HF may be due to either of what 2 dysfunctions? |
either Systolic or Diastolic dysfunction of the Left Ventricle
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DEFINITION
- in terms of blood in ventricles, what occurs in Systole? - what about Diastole? |
- ejects blood out of ventricle
- fills the ventricle with blood |
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DEFINITION
- Both Systolic and Diastolic dysfunction in HF is characterized how? - what is the difference? |
- Elevated LV filling pressure
- Underlying Hemodynamic processes (considerably different) |
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DEFINITION
-in CHF, what causes Pulmonary Congestion? - Systolic or Diastolic effect? |
- elevated LVEDP > 25 mmHg
- Diastolic |
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DEFINITION
- In diastole, what forms a common chamber? |
- LA
- LV - Pulmonary Vein |
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DEFINITION
- the Pulmonary vein is continuous with? |
- Pulmonary capillary bed
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DEFINITION
- what determines the Pulmonary capillary pressure? |
- LVEDP
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DEFINITION
- the LVEDP determines the presence or absence of what pathological condition? |
- Pulmonary Congestion or Edema
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DEFINITION
- in normal circumstances, describe the pressures of LA, LVEDP, and Pulmonary vein. - at what pressures would you see pathological Sx in patients? |
- all equal and less than 25 mmHg
(normal PCWP is 3 - 12 mmHg) - if pressure > 25 mmHg, we see symptoms |
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NYHA CHF CLASSIFICATION
- define Class I |
- Pt has Cardiac Dz
- Ordinary physical activity does NOT cause Sx |
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NYHA CHF CLASSIFICATION
- define Class II |
- Symptoms of HF with ordinary exertion
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NYHA CHF CLASSIFICATION
- define Class III |
- Symptoms with HF on less than ordinary exertion
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NYHA CHF CLASSIFICATION
- define Class IV |
- Symptoms of HF at rest
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ACC/AHA: HF STAGES
- Describe Stage A |
- High risk for HF
- No structural Heart Dz nor Sx |
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ACC/AHA: HF STAGES
- Describe Stage B |
- Heart Dz with
- Asymptomatic - LV Dysfunction |
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ACC/AHA: HF STAGES
- Describe Stage C |
- Prior or Current Sx of HF
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ACC/AHA: HF STAGES
- Describe Stage D |
- Advanced Heart Dz
and - Severely Symptomatic or Refractory HF |
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ACC/AHA: HF STAGES
- in contrast to NYHA classification, the ACC/AHA stages Emphasizes what? - and Defines what for each stage? |
- Progressive nature of HF
- Appropriate Therapeutic approach |
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ACC/AHA: HF STAGES
- Describe Hormone therapy for Stage A & B |
Increase (BNP)
- NPs (Natruretic Peptide) - PG (Prostaglandins) - BK (Bradykinins) |
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ACC/AHA: HF STAGES
- Describe Hormone therapy for Stage C & D |
Decrease RECS
- RAAS (Renin-Angiotensin-Aldersterone System) - ET (Endothelin) - Cytokines - SNS (Sympathetic NS) |
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CHF
- what are the top 3 causes of CHF in terms of diseases? |
- CAD
- HTN - Cardiomyopathy |
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CHF
- what CV factors contribute to worsening HF? x7 |
(SUN UW PE)
- Superimposed Ischemia or Infarct - Uncontrolled HTN - New onset or Uncontrolled A-Fib - Unrecognized Primary Valvular Dz - Worsening Secondary Mitral Regurgitation - PE - Excessive Tachycardia |
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CHF
- what Systemic factors contribute to worsening HF? x7 |
(SUITE PA)
- Superimposed Infection - Uncontrolled DM - Inappropriate MEDS - Thyroid DysF(x) - Electrolyte disorders - Pregnancy - Anemia |
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CHF
- what Patient related factors contribute to worsening HF? x4 |
(NADS)
- Noncompliance w/ MEDS - Alcohol - Diet - Substance abuse |
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CHF
- what are the MAJOR clinical manifestation of CHF? x8 |
(POET PCP W)
- Paroxysmal Nocturnal Dyspnea - Orthopnea - Elevated Jugular Venous Pressure - Third Heart Sounds - Pulmonary rales - Cardiomegaly on CXR - Pulmonary Edema on CXR - Wt. loss of >= 4.5 kg in 5 days (in response to Tx of presumed HF) |
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CHF
- what are the MINOR clinical manifestation of CHF? x8 |
(BND PT HW)
- Bilateral LE Edema - Nocturnal cough - DOE - Pleural Effusion - Tachycardia (HR > 120) - Hepatomegaly - Wt. loss >= 4.5 kg in five days |
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CHF
- what is the clinical criteria for the diagnosis of CHF? |
CONCURRENT
- 2 major or - 1 major & 2 minor |
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CHF
- a MINOR criteria is only acceptable if? |
- it can not be attributed to another medical condition
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CARDIOMYOPATHY
- define cardiomyopathy - and what must it take into consideration? x2 |
- All Diseases affecting Heart muscle
- Etiology - Dominant Pathophysiology |
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CHF
- what are the types? x5 |
(U HARD)
- Unclassified Cardiomyopathy - Hypertrophic Cardiomyopathy - Arrythmogenic RV Dysplasia - Restrictive Cardiomyopathy - Dilated Cardiomyopahty |
