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50 Cards in this Set
- Front
- Back
What is Heart Failure?
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Heart Failure is a condition in which the heart can't pump enough blood throughout the body
As a result, vital organs such as the brain, liver and kidneys are affected |
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What are the leading causes of Heart Failure?
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1) Coronary Artery Disease
2) Hypertension 3) Diabetes (High levels of lipid in the blood= atherosclerosis & hypertension) |
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What is Cardiomyopathy?
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Damage to the heart muscle
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Pathophysiology of heart failure
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See chart
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The Renin-Angiotensin-Aldosterone System (RAAS) in heart failure
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See chart
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How does the Heart compensate?
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1) The heart muscle thickens to compensate for increased volume: Ventricular hypertrophy
2) It may enlarge, which allows more blood into the heart: Ventricular dilatation 3) It may contract more frequently to increase circulation 4) Activation of kidney's neurohormonal sytem: salt & water retention |
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Symptoms?
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1) The heart's inability to pump blood and supply oxygen to organs
2) Congestion of the lungs with extra fluid 3)Lungs - Dyspnea - Orthopnea: Cant sleep at night |
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What is Acute Heart Failure Syndrome? (AHFS)
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Is defined as gradual or rapid change in Heart Failure signs & symptoms resulting in a need for urgent therapyé
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What are the precipitating factors?
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- Concurrent cardiovascular conditions (CHD, Hypertension,)
- Diabetes - Anemia |
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What are the symptoms?
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- Sudden fluid build-up
- Rapid irregular heartbeat with palpitations that may cause the heart to stop beating - Sudden , severe shortness of breath and coughing up pink, foamy mucus - Chest pain if caused by MI |
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Part of the heart affected by heart failure
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See Chart
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What are the Stages of Heart Failure Classification from NYHA (New York Heart Association)
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See Chart
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What is the newer classification system?
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American College of Cardiology Scale
(Uses letters A to D) Stage A; A person who has several risk factors for heart failure Stage D: A person with end-stage heart failure |
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How is it diagnosed?
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1. History
2. Examination 3. Investigations a- Blood tests: check kidneys and thyroid function b- Specific chemical markers of heart failure: Brain Natriuretic peptide (BNP) |
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Diagnose continued
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4. Chest X-Ray to check:
a- Condition of the lungs b- Size of the heart 5. ECG a- Heart rhythms problems b- Size of the heart 6. Echocardiogram - It helps determine the Ejection fraction 7. Strest test 8. Cardiac CT or MRI scans 9. Coronary catherization (Angiogram) |
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How is is treated?
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1. ACE Inhibitors
2. Diuretics 3. Vasodilators 4. Digitalis preparations 5. Beta Blockers 6. Blood thinners 7. Angiotensin II Receptor Blockers 8. Calcium Channel Blockers 9. Cholesterol-Lowering Drugs |
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How does Coronary Artery disease produce heart failure?
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The arteries become narrow or clogged, limiting blood supply to the heart
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How does Hypertension produce heart failure?
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Increased Blood Pressure causes the heart to overworked.
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How does Heart valve or Congenital heart defects produce heart failure?
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Increase volume or increase pressure leads to obstruction
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How does Arrhythmias produce heart failure?
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Abnormal heart rhythm causes heart to overwork
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Explain how Coronary artery disease produce heart failure?
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The arteries become narrowed or clogged, limiting blood supply to the heart
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Explain how hypertension produce heart failure?
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Increased BP causes the heart to go into tachycardia. Heart compensates too much (over works)
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Explain how Heart valve disease or Congenital heart defects produce heart failure?
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Increase volume or increase pressure leads to obstruction
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Explain how arrhythmias produce heart failure?
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Abnormal heart rhythm causes heart to overwork
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Explain how Diabetes produce heart failure?
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Increased lipids levels in the blood causes atherosclerosis and hypertension
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What are the symptoms of heart failure?
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Myocardial Infarction
Edema of lower limbs Dyspnea |
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What are the signs of Heart Failure?
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Sudden fluid build-up
Swollen or tender abdomen Sudden weight gain |
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Why is there dyspnea with heart failure?
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Increased pressure and/or extra fluid in the lungs
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Why is there oedema with heart failure?
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Systemic circuit can't return to heart, so it builds up in the legs (venous congestion)
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Why is there lack of appetite with heart failure?
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Due to a build up of fluid (congestion) around the liver & gut interfering with digestion
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What is Brain natriuretic peptide?
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It is a chemical marker that is secreted by the heart at high levels when it's injured or overworked
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Cite 3 medications used to treat heart failure?
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1) Beta-Blockers
2) ACE inhibitors 3) Diuretics |
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What is the drug of choice to treat heart failure?
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ACE inhibitors (Cardura)
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Why are ACE inhibitors useful in heart failure?
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Dilate the blood vessels so blood can flow through more easily. ( lower BP= blocks the conversion of Angiotensin I into Angiotensin II)
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Cite 3 side effects of ACE inhibitors?
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1) Persistent cough
2) Weakness & dizziness 3) Altered sense of taste |
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What category of medications do Lasix and Butamex belong to?
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Diuretics
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What is their mechanism of action?
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Help eliminate the extra water & sodium salt that causes swelling of the ankles, and shortness of breath
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Cite an important precaution with the use of such drugs?
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Important to eat food high in potassium because diuretics may cause loss of potassium
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Name a potassium sparing diuretic?
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Aldactone
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Why does a patient not need to take K+ supplements with Aldactione?
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Aldactone acts as an aldosterone antagonist meaning Na loss and K+ retention
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Cite a vasodilator?
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Apresoline
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What is their mechanism of action?
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Relaxes smooth muscles & widens blood vessels
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How do vasodilators produce "orthostatic hypotension"?
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Because vasodilators dilates arterioles & veins (abolish constriction)
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How does Digoxin (Lanoxin) improve the symptoms of heart failure?
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It increases the force of heart muscular and increases the COP. It also helps avoid rapid heart rhythms.
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Cite 2 precautions with the use of Lanoxin?
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1) Predispose to some arrhythmias
2) Hypokalcimia |
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Cite the advantage of administering a Beta blocker to a person suffering from heart failure?
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The failing heart tries to compensate for its weakened pumping action by beating faster, which puts more strain on it. Beta blockers reduce the heart's tendency to beat faster
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Cite the name of two Angiotensin II receptor blockers?
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1) Micardis
2) Diovan |
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Cite 2 side effects of these medications?
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Cough
High level of potassium |
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What are the dual effects of Calcium channel blockers on heart failure?
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Lower BP
Increase Coronary blood flow |
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Cite 3 side effects of calcium channel blockers?
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1) Headache
2) Dizziness 3) Drowsiness |