Wake Cv Heart Failure 2

Front 1

Physiologic Definition CHF

Back 1

The inability of the heart to maintain the circulatory demands of an organism associated with a rise in left ventricular pressure

Front 2

Causes of Cardiomyopathy

Back 2

- Ischemic
- Valvular
- HTN
- Tachycardia
- Familial Genetics
- Idiopathic
- Toxins
- Metabolic
- Infectious
- Systemic Dzs
- Allergic
- Peri-partum
- Neuromuscular

Front 3

Too much of these can cause CHF

Back 3

- Norepinephrine
- Angiotensin 2
- Aldosterone
- Endothelin
- Vasopressin
- TNF- alpha

* for tx, block these

Front 4

Too little of these can result in CSF

Back 4

- Nitric Oxide
- Kinins
- Naturetic peptides
- Immune Modulation

*for tx, increase these

Front 5

What are the three hemodynamic defense systems?

Back 5

1. Sympathetic Nervous System
2. Renin Angiotensin
3. Aldosterone

Front 6

Sympathetic Nervous System
What is the effector and the receptor for this hemodynamic defense system?

Back 6

Effector: Norepinephrine
Receptor:
- Beta (1-3)
- Alpha

Front 7

Renin Angiotensin
What is the effector and the receptor for this hemodynamic defense system?

Back 7

Effector: Angiotensin 2
Receptor: Angiotensin (1-2)

Front 8

Aldosterone
What is the effector and the receptor for this hemodynamic defense system?

Back 8

Effector: Aldosterone
Receptor: Mineralacorticoid

Front 9

Sympathetic Nervous System
Which organs are involved in this hemodynamic defense system?

Back 9

- Cardiovascular innervation
- Adrenal Gland

Front 10

Renin Angiotensin
Which organs are involved in this hemodynamic defense system?

Back 10

- Kidneys
- Lungs
- Cardiovascular

Front 11

Aldosterone
Which organs are involved in this hemodynamic defense system?

Back 11

- Kidneys
- Heart

Front 12

Sympathetic Nervous System
What are the cardiac effects for this hemodynamic defense system?

Back 12

- Increase Automaticity
- Increase Contractility
- Increase Afterload
- Myocyte death (when chronically stimulated)

Front 13

Renin Angiotensin
What are the cardiac effects for this hemodynamic defense system?

Back 13

- Increase Afterload
- Increase Preload
- Myocyte hypertrophy

Front 14

Aldosterone
What are the cardiac effects for this hemodynamic defense system?

Back 14

- increase afterload
- increase preload
- cardiac fibrosis

Front 15

Syndrome

Back 15

Constellation of signs and symptoms that taken together suggest presence of a specific disease

Front 16

Signs

Back 16

Objective features of an illness detected by a practitioner

Front 17

Symptoms

Back 17

Subjective features of an illness as related by the patient

Front 18

Clinical Definition of Heart Failure

Back 18

Clinical syndrome that can result from any structural or functional cardiac disorder that IMPAIRS THE ABILITY OF THE HEART TO FILL WITH OR EJECT BLOOD

Front 19

CHF
ACC/AHA Stage A

Back 19

high risk, but no structural changes

Front 20

CHF
ACC/AHA Stage B

Back 20

structural changes without syndrome

Front 21

CHF
ACC/AHA Stage C

Back 21

structural changes and syndrome CONTROLLED with therapy

Front 22

CHF
ACC/AHA Stage D

Back 22

structural changes and syndrome UNcontrolled DESPITE therapy

Front 23

What comorbidities are associated with Stage A of CHF?

Back 23

HTN
CAD
DM

Front 24

In the Staging of CHF, which stages actually have symptoms?

Back 24

- Stages C and D, which is why these stages are also classified by symptoms

Front 25

What is the survival rate at 7 years with symptomatic CHF?

Back 25

10%

Front 26

CHF
NYHA Class 1

Back 26

No limitation of (day-to-day) activity

Front 27

CHF
NYHA Class 2

Back 27

Mild limitation of activity, improves by slowing down

Front 28

CHF
NYHA Class 3

Back 28

Marked limitation, improve with rest

Front 29

CHF
NYHA Class 4

Back 29

Severe limitation or symptoms at rest

Front 30

Diastolic Heart Failure
vs.
Systolic Heart Failure
(Age, Gender)

Back 30

DHF = Older and Female

SHF = Younger and Male

Front 31

Diastolic Heart Failure
vs.
Systolic Heart Failure
(Morbidity and Mortality)

Back 31

Both DHF and SHF have a 50% re-hospitalization rate within 6 months

- 5% annual mortality with DHF

- 10% annual mortality with SHF

Front 32

Diastolic Heart Failure
vs.
Systolic Heart Failure
(Prevalence of outpatient and hospitalizations)

Back 32

40% for Diastolic HF
60% for Systolic HF

Front 33

What are the structural changes in the LV with DHF?

Back 33

- INCREASE mass
- NO volume change
- type of hypertrophy: CONCENTRIC

Front 34

What are the structural changes in the LV with SHF?

Back 34

- INCREASE mass
- INCREASE volume
- type of hypertrophy: ECCENTRIC

Front 35

Are there changes in systolic and/or diastolic funtion with DHF?

Back 35

Decrease in diastolic function

(unable to fill)

Diastolic function changes only

Front 36

Are there changes in systolic and/or diastolic funtion with SHF?

Back 36

Decrease in diastolic AND systolic function

(unable to pump and unable to fill)