Term
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Definition
| Impaired cardiac function that is associated w/ abnormal contractile function of the heart. |
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Term
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Definition
| Inability of the heart to pump blood forward at a sufficient rate to meet the metabolic demands of the body. |
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Term
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Definition
| the ability to pump blood forward at a sufficient rate only if the cardiac filling pressures are abnormally high |
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Term
| What is meant by HF being on a continuum? |
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Definition
| You can go in and out of acute and chronic failure. |
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Term
| What is the difference in presentation btw chronic and acute HF? |
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Definition
| Chronic: Signs and Sx are most obvious w/ exercise, might not see anything abnormal at rest. Acute: Signs and Sx don't look normal at rest, necessarily. |
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Term
| Signs and Sx of HF are secondary compensatory mechanisms related to the interaction of what three major things via what system? |
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Definition
| Heart, peripheral circulation and other body organs such as the kidneys, via the hormonal system. |
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Term
| What are the major systolic and diastolic causes of heart failure? (2 in each category) |
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Definition
| Systolic: Impaired contractility, Increased Afterload. Diastolic: Impaired ventricular relaxation, Obstruction of LV filling. |
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Term
| What are the three major causes of impaired contractility? |
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Definition
| MI (primarily), Transient MI, Chronic volume overload. |
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Term
| What are the two causes of increased afterload? |
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Definition
| Aortic stenosis and Uncontrolled HTN. |
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Term
| Is it safe to exercise a pt w/ aortic stenosis? |
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Definition
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Term
| What are some reasons for impaired ventricular relaxation? (4) |
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Definition
| LV hypertrophy, hypertrophic cardiomyopathy, restrictive cardiomyopathy, transient MI. |
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Term
| Why does LV hypertrophy result in decreased blood flow out of the heart? |
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Definition
| The wall is thickened so the chamber is smaller, and it holds less blood. |
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Term
| What are the two causes of obstructed LV filling? |
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Definition
| mitral stenosis and pericardial constriction/tamponade. |
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Term
| Describe The classes of NYHA Classification of HF.(4) |
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Definition
| I: Pts w/ no limitation of activities, suffer no Sx from ordinary activities. II: Slight, mild limitation of activity, comfortable @ rest or w/ mild exertion. III: Marked limitation of activity, comfortable only at rest. IV: Should be at complete bed rest, confined to bed or chair. Any physical activity brings discomfort and Sx occur at rest. |
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Term
| What are the major Signs of HF? (3) |
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Definition
| Fatigue, Dyspnea, Swelling (lower legs/abdomen). |
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Term
| What kinds of dyspnea are common w/ HF? |
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Definition
| exertional, orthopnea and paroxysmal nocturnal. |
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Term
| What are the signs of HF? |
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Definition
| 1. Tacy, 2. SBP<90 3. JVD 4. Abnormal hepatojugular reflex 5. Abnormal apex beat 6. Third heart sound 7. Inspiratory crackles on lung auscultation 8. Edema (peripheral and pulmonary) |
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Term
| What are the consequences of HF on the heart? |
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Definition
1. Changes in ventricular size and shape. 2. Myocyte dysfunction due to death or increased apoptosis. 3. Increased collagen deposition. 4. Increased protease activity - myocyte disorganization/dysfunction. 5.Abnormal myocyte contractility
6. Desnsitization of cardiac B receptors
7. Abnormal Ca homeostasis
8. Abnormal contractile protein function
9. Oxidative stress – free radical damage. |
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Term
| Is LBBB common in HF pts? |
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Definition
| Yup ~40% HF pts have LBBB |
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