Heart Failure

Front 1

What are the three main compensatory mechanisms that are activated in heart failure?

Back 1

SNS activation, increased preload and myocardial hypertrophy.

Front 2

What is cardiac hypertrophy stimulated by?

Back 2

Elevated myocardial wall tension and the growth-promoting actions of neurohormones.

Front 3

What is dyspnea and when does it occur in heart failure?

Back 3

Breathlessness and it occurs early in the progression of left-sided heart failure and may be considered the main symptom.

Front 4

What is cyanosis?

Back 4

This is the blue coloration of the skin usually seen around the mouth.

Front 5

What is biventricular heart failure?

Back 5

This is usually the result of primary left ventricular failure that progressed to right sided heart failure.

Front 6

What are some symptoms of insufficient cardiac output?

Back 6

Confusion, fatigue, tachycardia, reduced urine output, and poor peripheral circulation.

Front 7

What are some signs of left sided heart failure?

Back 7

Dyspnea, orthopnea, crackles, cough, pulmonary edema and hypoxemia

Front 8

How is heart failure diagnosed?

Back 8

Signs and symptoms, x-ray findings, and echocardiographic findings.

Front 9

What are the primary reason for treatment of heart failure?

Back 9

Improve cardiac output, minimize congestive symptoms and prevent progression.

Front 10

What are two things that have been shown to improve mortaility risks in patients with heart failure characterized by low EF?

Back 10

ACE inhibitors and B-blocking agents

Front 11

What is dysrhythmia?

Back 11

An abnormality of the cardiac rhythm of impulse generation or conduction.

Front 12

What factors may lead to disturbances of heart beat?

Back 12

Hypoxia, electrolyte imbalance, trauma, inflammation, and drugs.

Front 13

Why are dysrhythmias significant?

Back 13

.1) They indicate an underlying pathopysiologic disorder
2) They can impair normal cardiac output

Front 14

When does a triggered activity occur?

Back 14

It occurs when an impulse is generated during or just after repolarization because of a depolarizing oscillation of membrane potential.

Front 15

Dysrhythmias are initiated by what three types of depolarizing mechanisms?

Back 15

Abnormal automaticity, triggered activity from afterdepolarizations, and reentrant circuits.

Front 16

What is sinus tachycardia?

Back 16

An abnormally fast heart rate of greater that 100 beats per minute.

Front 17

What factors can lead to sinus tachycardia?

Back 17

Sympathetic activation, decreased parasympathetic activity, fever, hyperthyroidism, pain, increased metabolism, low blood pressure and hypoxia.

Front 18

Can sinus bradycardia be a normal finding in a well conditioned individual?

Back 18

Yes it can be a normal finding.

Front 19

What is sick sinus syndrome?

Back 19

There is alternating periods of sinus bradycardia and tachycardia that occur.

Front 20

If you have sick sinus syndrome what may have to be done?

Back 20

This may necessitate implantation of a permanent pacemaker.

Front 21

What would an ECG show with asystole?

Back 21

This is a flat line on an ECG lacking recognizable waveforms.

Front 22

Is sinus arrhythmia usually normal and more pronounced in younger or older persons?

Back 22

Younger persons

Front 23

Where can escape beats originate?

Back 23

In the AV nodal region, or in the ventricular Purkinje fibers.

Front 24

What is ventricular fibrilation?

Back 24

A rapid, uncoordinated cardiac rhythm that results in ventricular quivering and lack of effective contraction.

Front 25

What do atrial dysthythmias include?

Back 25

Premature atrial complexes, tachycardia, flutter, and fibrillation.

Front 26

What is an atrioventricular block?

Back 26

This is a disturbance in conduction between the sinus impulse and its associated ventricular response.

Front 27

What is an AV block?

Back 27

These are disturbances of AV conduction.

Front 28

What is heart failure?

Back 28

A potential consequence of most cardiac disorders. Occurs when the heart is unable to provide sufficient cardiac output to meet normal metabolic functions of body.

Front 29

What is the most common cause of heart failure?

Back 29

Myocardial ischemia from coronary artery disease.

Front 30

What are other causes of heart failure?

Back 30

Hypertension and dilated cardiomyopathy.

Front 31

How do you calculate ejection fraction?

Back 31

Dividing stroke volume by end-diastolic volume

Front 32

A patient with a low ejection fraction, less than 40 percent.

Back 32

Systolic failure

Front 33

What are the two main causes of diastolic dysfunction?

Back 33

Ischemic heart disease and hypertension

Front 34

Sympathetic activation of the heart is primarily the result of what?

Back 34

Baroreceptor reflex stimulation

Front 35

Where are baroreceptors located?

Back 35

In the aorta and carotid arteries

Front 36

What do baroreceptors do?

Back 36

Detect a fall in pressure due to diminished stroke volume and trnasmit this information to the central nervous system.

Front 37

What do juxtaglomerular cell do?

Back 37

They release renin and initiate the renin-angiotensin-aldosterone cascade.

Front 38

What is a first degree block characterized by?

Back 38

A prolonged PR interval and usually requires no treatment.

Front 39

What are the two types of second degree block?

Back 39

Type I (Wenckerbach) is a progressive prolongation of the PR interval until P wave is not conducted.
Type II is a rhythm showing a consistent PR interval with some nonconducted P waves.

Front 40

Which of the second degree blocks is more serious?

Back 40

Type II because it can progress into a third degree block.

Front 41

What is a third degree block?

Back 41

This is a complete heart block.

Front 42

What are backwards effects caused by?

Back 42

Congestion of blood behind the ineffectively pumping ventricle.

Front 43

Where is the congestion located in left-sided heart failure?

Back 43

The lungs.

Front 44

What are three major types of dysrhythmias?

Back 44

1)abnormal rates of sinus rhythm.
2) abnormal sites of impulse initiation. 3)disturbances in conduction pathways.

Front 45

What is preload?

Back 45

The volume of blood in the ventricles at the end of diastole.

Front 46

What is afterload?

Back 46

The peripheral resistance against which the left ventricle must pump.

Front 47

What are the three neurohormonal responses?

Back 47

1)Heart begins to fail causing decreased CO and decreased BP
2)Perfusion to the kidneys decrease.
3)Ventricular remodeling

Front 48

What is the potential consequence of most cardia disorders?

Back 48

Heart failure

Front 49

In who is heart failure most likely to develop?

Back 49

Elderly, woman, and those without history of MI

Front 50

What is heart failure?

Back 50

A complex clinical syndrome resulting from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood.

Front 51

What are the neurohormones that worsen heart failure?

Back 51

1)RAAS- renin, angiotensin, aldosterone
2)SNS-epi & norepi
3)ET-endothelin

Front 52

What are the neurohormones that are beneficial in heart failure?

Back 52

1)ANP-atrial natriuretic peptide
2)BNP-B-type natriuretic peptide
3)CNP-C-type natriuretic peptide.

Front 53

What is the most common cause of heart failure?

Back 53

Systolic heart failure

Front 54

What is systolic heart failure?

Back 54

Causes ventricle not to empty properly.

Front 55

What is Diastolic heart failure?

Back 55

Causes ventricle not to fill properly.

Front 56

Which ventricle is more common to fail?

Back 56

Left ventricular failure.

Front 57

What is the most common cause of biventricular heart failure?

Back 57

Most often result of primary left sided heart failure progressing to right sided heart failure.

Front 58

Why are pacemakers used?

Back 58

To help synchronize ventricular contraction.