Heart Failure

Question 1

What is congestive heart failure (CHF)?

Answer 1

heart unable to pump blood at rate required by tissues of the body OR able to but at elevated filling pressures

Question 2

Types of CHF?

Answer 2

Systolic: deterioration of contractile function
Diastolic: Cant accommodate ventricular blood volume

Question 3

CHF S&S

Answer 3

• breathlessness
• abnormal retention of sodium + water
• Result: edema w/ congestion of lungs OR peripheral circulation OR BOTH

Question 4

CHF Rx

Answer 4

• Treat underlying cause
• Reduce symptoms (lifestyle modification)
• May require pacemaker, VAD, valve replacement, heart transplant, etc.

Question 5

Left sided heart failure =

Answer 5

Congestive heart failure

Question 6

Major causes of left sided heart failure

Answer 6

ischemic heart disease
hypertension
aortic and/or mitral valve disease
myocardial disease

Question 7

results of left sided heart failure

Answer 7

damming of blood in pulmonary circulation

Question 8

Left sided heart failure S&S

Answer 8

• SOB when lying
• Nocturnal gasp of breath when sleeping
• Dec. kidney and brain perfusion
• exertional dyspnea
• pulmonary congestion: cough, crackles, wheezes

Question 9

What are the major causes of right sided heart failure

Answer 9

Left sided heart failure

Chronic severe pulmonary hypertension

Question 10

What is the result of right sided heart failure

Answer 10

damming of blood in systemic and portal venous systems

• Decreased flow in periphery
• pitting edema (Increased peripheral venous pressure)
• congestion of the portal system causing liver damage + enlarged spleen
• kidney and brain issues
• fatigue

Question 11

What is Cor Pulmonale?

Answer 11

abnormal enlargement of the right side of the heart as a result of disease of the lungs or the pulmonary blood vessels.

Question 12

What are the causes of cor pulmonale?

Answer 12

• Long term increase in BP in lung arteries + R ventricle - Chronic severe pulmonary hypertension
• emphysema, chronic brochitis (COPD)
• cystic fibrosis `

Question 13

What causes ischemic heart disease

Answer 13

Myocardial ischemia

Question 14

Ischemic heart disaese S&S

Answer 14

• Angina
• MI
• Sudden cardiac death 90% due to atherosclerosis

Question 15

What is angina pectoris

Answer 15

paroxysmal (sudden attack, short and frequent) recurrent episodes of chest discomfort

Question 16

Angina pectoris causes

Answer 16

Transient ischemia of heart muscle due to obstruction and/or spasm of coronary arteries
- CAN BE: stable, unstable, prinzmetal (variant angina) occurs at rest

Question 17

What is myocardial infarct

Answer 17

Blood not flowing properly to part of heart muscles - injury due to lack of O2

Question 18

Myocardial infarct risk factors

Answer 18

• Previous cardiovascular disease
• Old age
• Smoking
• High levels of certain lipids

Question 19

Myocardial infarct causes

Answer 19

Coronary artery to heart develops blockage d/t unstable atheroma’s (WBCs + cholesterol + triglycerides)

Question 20

Myocardial infarct S&S

Answer 20

• Sudden chest pain
• L UE/neck pain
• May have: SOB, sweating, nausea, vomiting, abnormal heartbeats, anxiety
• M>F in having symptoms

Question 21

Myocardial infarct Ax

Answer 21

• Blood test for troponin + creatine kinase

- ECG: differentiate btw types of MIs - STEMI (ST Elevation MI): higher ST segment - requires more aggressive treatment

Question 22

Myocardial infarct Rx

Answer 22

• Aspirin (immediate): prevents further blood clotting
• Nitroglycerin: treat chest pain + O2 delivery
• Angioplasty (opening artery back up)
• Thrombolysis (blockage removed w/ meds)
• Bypass surgery (especially if have diabetes or multiple blockages)