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13 Cards in this Set
- Front
- Back
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What is cardiac reserve?
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the ability to increase cardiac output during increased activity
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Describe the 2 factors that contribute to the pathophysiology of heart failure
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• 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 |
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What are the main components of afterload?
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• systemic (peripheral) vascular resistance
• ventricular wall tension |
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What are adaptive mechanisms in heart failure to maintain cardiac reserve?
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• Frank-Starling Mechanism
• activation of sympathetic nervous system • activation of renin-angiotensin-aldosterone mechanism • increase in ANP and BNP |
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Name and describe the 3 types of hypertrophy
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• 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 |
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What is the difference between high-outpuut and low-output failure?
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• 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) |
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What is the difference between systolic and diastolic failure?
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• 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 |
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What are the most common causes of left-sided heart failure?
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• acute MI
• cardiomyopathy |
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What are manifestations of CHF?
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• fluid retention and edema
• respiratory manifestations • fatigue and limited exercise tolerance • cachexia and malnutrition • cyanosis |
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What is the difference between orthopnea and paroxysmal nocturnal dyspnea?
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• Orthopnea is shortness of breath that occurs when a person is supine
• PND is a dudden sttack of dyspnea hat occurs during sleep |
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What is the difference in causes of central and peripheral cyanosis?
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• 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 |
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Describe the NYHA classification of heart failure
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• 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 |
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Describe the AHA/ACC classification of heart failure
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• 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 |
