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16 Cards in this Set
- Front
- Back
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Decompensation |
the ventricle can’t maintain strokevolumes that match incoming venous returns --> back up in pressure |
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Decompensation of LVF |
•Increased pulmonary venouspressure •Increased pulmonary capillary pressure •Interstitial Edema •Alveolar Edema |
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Decompensation of RVF |
•increased central venous pressure •Increased systemic capillary pressure •Interstitial edema •Pitting edema of dependent tissues (particularly feet, ankles, legs) |
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Risk Factors of Congestive Heart Failure |
•Previous heart attacks •Coronary artery disease •High blood pressure (hypertension) •Irregular heart beat (arrhythmia) •Heart valve disease (especially of the aortic & mitral valves) •Cardiomyopathy (disease of the heart muscle) •Congenital heart defects (defects you are born with) •Alcohol & drug abuse |
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Symptom of Congestive Heart Failure/decompensation (all caused from LVF) |
•Orthopnea •Paroxysmal nocturnal dyspnea (PND) •Dyspnea on exertion (DOE) •Fatigue: tired,weak, limited exercise tolerance •weight gain from excess fluid •chest pain --> myocardial ischemia •Jugular vein distention (JVD) •nocturia •neck veins are swollen •skin - cold and sweaty •pulse - fast or irregular •restless, confused, attention span and memory compromised •GI symptoms - loss of appetite, indegestion |
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Orthopnea |
shortness of breath when lying flat, causing the person to have to sleep propped up in bed or sitting in a chair -increase in venous return -pulmonary edema causes SOB |
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Paroxysmal nocturnal dyspnea (PND) |
SOB caused by pulmonary congestion and edema after 1-2 hours of sleep -rapid onset of SOB |
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Jugular vein distention (JVD) |
• increased venous pressure |
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nocturia |
•excessive urination at night --> fluid redistribution while reclining -Increases venous return |
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Symptoms of LVF |
Increase pulmonary hypertension --> blood & fluid back up into your lungs --> RV continues to pump blood to thelungs fatigue, dyspnea, othopnea, Paroxysmal (intermittent) nocturnal dyspnea, pulmonary edema, blood-tinged sputum |
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Symptoms of RVF |
•reduced ejection volume --> buildup of fluid in your veins and increase in CVP •Systemic edema: -dependent edema -hepatomegaly: enlargement or swelling of the liver -Ascites: fluid in the abdominal cavity -skin & soft tissues: swelling of the feet, ankles, legs •nocturia |
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Diagnosis of Congestive Heart Failure |
•tentative Dx: edema and SOB •ausculatation: rales - crackling breath sounds, heart murmur, rapid HR •chest x-ray: cardiomegaly, pulmonary edema •ECG: arrhythmia •Echocardiography: valve function, heart wallmotion, and overall heart size |
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Precipitating causes of Congestive Heart Failure |
•Non Compliance with Meds and Diet •Acute MI •Arrhythmia •Pneumonia •Increased Sodium Diet (HolidayFailure) •Anxiety |
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Emergent Management of Congestive Heart Failure |
•Sit upright •High Flow O2 •NTG (If SBP > 100) - reduce BP rate •Diuretics (Lasix) •Rotating Tourniquets - rotating order to pool blood in the extremities to increase venous return •Ventilatory Support: CPAP, intubation/ventilation |
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Chronic Congestive Heart Failure Lifestyle Treatment |
•weight loss •decrease dietary salt •increase O2– supplemental •smoking cessation •control high blood pressure, cholesterol levels, and diabetes. •diet - low in calories, saturated fat, and salt. •limit alcohol consumption •limit fluid intake •weigh daily to identify fluid retention •physician approved aerobic exercise program |
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Chronic Congestive Heart Failure Drug Treatment |
•Treat cause – arrhythmias •Diuretics – dieresis – decreasefluid load on heart •Inotropics (ex: digitalis) strengthen heart's ability to pump •Vasodilators (ex: nitroglycerin), to dialate narrowed vessels. •Antihypertensives: -Calcium channel blockers - keep vessels open and lower blood pressure -Beta-blockers - help increase ability to exercise and improve symptoms over time -ACE inhibitors - keep vessels open and lower blood pressure -Angiotensin II receptor blockers- keep vessels open and lower blood pressure. |
