Patho - Exam 3 Heart Failure And Arrhythmias

Front 1

Causes of heart failure:

Back 1

1. diminished myocardial contractilibility
2. increased myocardial workload

Front 2

Causes of decreased myocardial contractibility:

Back 2

1. decrease in beta receptors (overexcited heart, not responding to drugs)
2. diastolic dysfunction (unable to remove Ca ions)
3. reduced stroke volume (low ejection fraction)

Front 3

What is the normal ejection fraction?

Back 3

normally 2/3 of preload

Front 4

Causes of increased myocardial workload:

Back 4

1. heart rate
2. increased volume work (blood regurg)
3. increased pressure (stenotic or obstructive)

Front 5

List the compensatory mechanisms of heart failure:

Back 5

1. cardiac reserve (HR increases)
2. Sympathetic NS (vasoconstrictors help maintan BP)
3. increased preload
4. myocardial hypertrophy

Front 6

Why is increased preload considered a compensatory response to heart failure?

Back 6

-causes cardiac dilation
-decreases glomerular filtration rate
-increases blood volume
-can cause better contractions

Front 7

What do the compensatory mechanisms for heart failure result in?

Back 7

increase in myocardial work and an increase in oxygen requirements

Front 8

4 Causes of LHF:

Back 8

1. MI of the LV (less contractiblity)
2. cardiomyopathy (less contractiblity)
3. aortic and mitral valve disease (more work)
4. systemic HTN (more work)

Front 9

What does LHF result in?

Back 9

1. inadequate perfusion to the body, esp brain and organs
2. decreased renal perfusion causing fluid retention (renal failure)
3. pulmonary congestion (edema)

Front 10

Causes of RHF:

Back 10

1. those included in LHF
2. pulmonary disorders
3. pure RHF

Front 11

"Pure" RHF:

Back 11

-rare dt very few rt sided infarcts
-lack of delivering adequate blood to the left side of the heart
-backward effects caused by venous congestion, peripheral edema, organ dysfunction

Front 12

Corpulmonale:

Back 12

-RV hypertrophy caused by pulmonary disorders

Front 13

3 types of heart failure:

Back 13

1. LHF
2. RHF
3. Biventricular failure

Front 14

Tx for HF:

Back 14

1. reduce BV by diuretics, salt/fluid reduction, ACE inhibitors
2. decrease resistance by ACE inhibitors, Ca channel blockers, antiadrenergics, vasodilators (morphine, nitro)
3. manage contractility by digitalis and dopamine

Front 15

Causes of cardiac arrhythmias:

Back 15

1. hypoxia
2. electrolyte imbalance
3. trauma
4. inflammation
5. drugs

Front 16

List 4 types of abnormal rates of sinus rhythm:

Back 16

1. sinus tachycardia
2. sinus bradycardia
3. sinus arrhythmia
4. asystole

Front 17

escape rhythm:

Back 17

-premature contractions
-originates in the AV node or Purkinje fibers
-usually no P wave
-pacemaker

Front 18

premature atrial complexes:

Back 18

-usually not significant
-if frequent, underlying pathology

Front 19

paroxysmal atrial tachycardia:

Back 19

-varies in length
-burst of PAC's (160-220 bpm)
-can last minutes to days

Front 20

atrial flutter:

Back 20

-220-350 bpm
-usually underlying heart disease
-ventricular rate may be irregular or with heart block

Front 21

List the 4 conduction pathway disturbances.

Back 21

1. 1st degree block
2. 2nd degree block
3. 3rd degree block
4. Intraventricular conduction defects

Front 22

ABNORMAL RHYTHMS NOT ADDED

Back 22

ABNORMAL RHYTHMS NOT ADDED