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23 Cards in this Set
- Front
- Back
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What are the broad categories of congestive failure?
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loss of contractility
loss of muscle mass pressure overload volume overload diastoic disfunction |
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What are the consequences of LV dysfuntion?
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vasoconstiction
neurohumoral stimulation LV remodeling |
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What does vasoconstriction cause?
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dec skeletal m flow -> exercise intolerance
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What does neurohumoral stimulation cause?
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dec renal flow -> Na retention -> edema
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What do LV remodeling issues cause?
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pump failure -> arrhythmias -> sudden cardiac death
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What do angiotension receptor signal?
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vasoconstsriction
aldosterone secretion sympathetic activation |
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What does an ACE inhibitor do?
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stop vasocontrict
dec aldosterone inc bradykinin |
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What are the salt and water issues in CHF?
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effective arterial vol is the goal. sensed as abnormal if PVR is dec or CO is low
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If effective arterial vol is low what happens?
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non-osmotic AVP release
inc symp tone activate renin-angiothensin to dec excretion of Na/H2O |
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Dec CO or preipheral vasodilatiaion causes renal vasoconstricion that causes?
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dec GFR -> dec Na/H2O delivery -> impaired escape from aldosterone & ANP resist
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Decreased CO or peripheral vasodiliation cause dec renal perfusion pressuer that causes?
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inc proximal tubular Na & H2O absorption -> dec distal Na & water -> impared escape from aldoserone & ANP resistance
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Dec CO or peripheral vasodilitation causes inc alpha adrenergic activity which causes?
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inc proximal tubular absorption of Na & H20 -> dec distal Na/H20 -> inc effects of aldosterone & dec effect of ANP
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Dec CO or peripheral vasodilatation causes inc Ang II activity which causes?
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inc ang II activity -> inc proximal tubular absorption -> inc effects of aldoseterone and dec effects of ANP
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What are you looking for in a history?
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exertional dyspnea
othopnea parozysmal nocturnal dyspnea fatigue & weakness nocturia functional capacity |
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What are you looking for on a physical exam?
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cardiomegaly
neck veins gallops systolic murmurs pulsus alternans pulmonary exam |
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What does aldosterone do simplisticly?
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increases preload
enhances fibrosis edema |
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What can you see on electrocardiography?
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cardiac rhythm
hypertrophy non-coronary loss of myocardium paricaridal problems |
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What cand you see on a chest X-ray?
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size & shape
vascular and lung fields pleurals space for effusion |
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What can you see on echo?
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chamber size & shape
valvular structures pericardial space doppler flow |
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What are major criteria of CHF?
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PND or orthopnea
neck vein distention rales bilaterally cardiomegaly S3 hepatojugular reflux |
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What are minor criteria of CHF?
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peripheral edema
dyspnea on exertion night cough pleural effusion tachycardia |
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What are some confounding extra cardiac problems assoicated with CHF?
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anemia
AV fistulas - aquired Hyperthyroidism Beriberi Paget's disease Liver diseas |
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What are some confounding cardiac problems in CHF?
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arrhythmias
infection pulmonary emboulus medications additional heart disease |
