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13 Cards in this Set

  • Front
  • Back
What is cardiac reserve?
the ability to increase cardiac output during increased activity
Describe the 2 factors that contribute to the pathophysiology of heart failure
• a decrease in pumping ability of the heart w/ a consequent decrease in cardiac reserve

• adaptive mechanisms that serve to maintain cardiac output while aslso contributing to the progression of heart failure
What are the main components of afterload?
• systemic (peripheral) vascular resistance
• ventricular wall tension
What are adaptive mechanisms in heart failure to maintain cardiac reserve?
• Frank-Starling Mechanism
• activation of sympathetic nervous system
• activation of renin-angiotensin-aldosterone mechanism
• increase in ANP and BNP
Name and describe the 3 types of hypertrophy
• symmetric hypertrophy: proportionate increase in muscle length and width; seen in atheletes

• concentric hypertrophy: an increase in wall thickness, seen in hypertension; stimulated by pressure overload

• eccentric hypertrophy: a disproportionate increase in muscle length; seen in dilated cardiomyopathy; stimulated by ventricular volume overload
What is the difference between high-outpuut and low-output failure?
• high-output failure: caused by an excessive need for cardiac output (ex. anemia, thyrotoxicosis, AV shunting, Paget's disease)

• low-output failure: caused by disorders that impair the pumping ability of the heart (ex. ischemic heart disease, cardiomyopathy)
What is the difference between systolic and diastolic failure?
• systolic dysfunction involves a decrease in cardiac contractility and ejection fraction

• diastolic dysfunction is characterized by a smaller ventricular chamber size, ventricular hypertropy, and poor ventricular compliance
What are the most common causes of left-sided heart failure?
• acute MI
• cardiomyopathy
What are manifestations of CHF?
• fluid retention and edema
• respiratory manifestations
• fatigue and limited exercise tolerance
• cachexia and malnutrition
• cyanosis
What is the difference between orthopnea and paroxysmal nocturnal dyspnea?
• Orthopnea is shortness of breath that occurs when a person is supine
• PND is a dudden sttack of dyspnea hat occurs during sleep
What is the difference in causes of central and peripheral cyanosis?
• Central cyanosis is caused by conditions that impair oxygenation of teh arterial blood (ex. pulmonary edema, left heart failure, right-to-left shunting)

• Peripheral cyanosis is caused by delivery of poorly oxygenated blood to peripheral tissues or by conditions that cause excessive removal of oxygen from the blood
Describe the NYHA classification of heart failure
• Class I: patients w/ cardiac disease but w/o limitation in physical activity

• Class II: patients w/ cardiac disease resulting in slight limitations of physical activity; ordinary physical activity produces symptoms

• Class III: patients w/ cardiac disease resulting in marked lmiitation of physical activity; less than ordinary physical activity produces symptoms

• Class IV: patients w/ cardiac disease resulting in in ability to carry on any physical activity w/o discomfort; symptoms present at rest
Describe the AHA/ACC classification of heart failure
• Class A: high risk of left-ventricular dysfunction (ex. HTN, CAD, DM, family hx of cardiomyopathy); no structural or functional abnormailites; no symptoms of heart failure

• Class B: patients with structural heart disease (ex. previous MI, left ventricle dysfunction), but are asymptomatic

• Class C: patients who are symptomatic for heart failure with underlying structural heart disease

• Class D: patients with advanced structural heart disease and marked symptoms of heart failure at rest despite maximum medical therapy