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22 Cards in this Set

  • Front
  • Back
Causes of heart failure:
1. diminished myocardial contractilibility
2. increased myocardial workload
Causes of decreased myocardial contractibility:
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)
What is the normal ejection fraction?
normally 2/3 of preload
Causes of increased myocardial workload:
1. heart rate
2. increased volume work (blood regurg)
3. increased pressure (stenotic or obstructive)
List the compensatory mechanisms of heart failure:
1. cardiac reserve (HR increases)
2. Sympathetic NS (vasoconstrictors help maintan BP)
3. increased preload
4. myocardial hypertrophy
Why is increased preload considered a compensatory response to heart failure?
-causes cardiac dilation
-decreases glomerular filtration rate
-increases blood volume
-can cause better contractions
What do the compensatory mechanisms for heart failure result in?
increase in myocardial work and an increase in oxygen requirements
4 Causes of LHF:
1. MI of the LV (less contractiblity)
2. cardiomyopathy (less contractiblity)
3. aortic and mitral valve disease (more work)
4. systemic HTN (more work)
What does LHF result in?
1. inadequate perfusion to the body, esp brain and organs
2. decreased renal perfusion causing fluid retention (renal failure)
3. pulmonary congestion (edema)
Causes of RHF:
1. those included in LHF
2. pulmonary disorders
3. pure RHF
"Pure" RHF:
-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
-RV hypertrophy caused by pulmonary disorders
3 types of heart failure:
1. LHF
2. RHF
3. Biventricular failure
Tx for HF:
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
Causes of cardiac arrhythmias:
1. hypoxia
2. electrolyte imbalance
3. trauma
4. inflammation
5. drugs
List 4 types of abnormal rates of sinus rhythm:
1. sinus tachycardia
2. sinus bradycardia
3. sinus arrhythmia
4. asystole
escape rhythm:
-premature contractions
-originates in the AV node or Purkinje fibers
-usually no P wave
premature atrial complexes:
-usually not significant
-if frequent, underlying pathology
paroxysmal atrial tachycardia:
-varies in length
-burst of PAC's (160-220 bpm)
-can last minutes to days
atrial flutter:
-220-350 bpm
-usually underlying heart disease
-ventricular rate may be irregular or with heart block
List the 4 conduction pathway disturbances.
1. 1st degree block
2. 2nd degree block
3. 3rd degree block
4. Intraventricular conduction defects