Term
Heart Failure
Dilated Cardiomyopathy |
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Definition
-the combo of symptoms related to the hearts inability to meet the demands of the body; NOT the disease, just the sx
-heart function is impaired due to pump failure and associated w/vent. dilation and hypertropy |
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Term
Acute Heart Failure
Chronic Heart Failure |
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Definition
- usually short term fluid overload symptoms
- evolves overtime and will get remodeling/structural and neurohormonal changes |
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Term
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Definition
- stable heart failure symptoms and the body/heart is used to/adjusted to the decreased pumping ability
- get worsening heart failure symptoms (esp. at rest!) and the body poorly tolerates the decreased pumping ability |
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Term
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Definition
- get LOW OUTPUT symptoms!
have decreased CO; blood doesn't get out of the heart good enough and will pool in the pulmonary vasc.; get dyspnea and fatigue |
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Term
| Right-sided Heart Failure |
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Definition
| - "LOW VOLUME" symptoms; usually follows left-sided hf; since prob with right side of heart pumping, blood backs up in systemic vasc. and may be JVD, peripheral edema, and hepatic congestion |
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Term
In heart failure, the _____ is activated leading to
1.
2.
3. |
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Definition
SNS (symp. nervous system)
1. increased HR
2. increased contraction force
3. peripheral vasoconstriction |
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Term
| Initially in HF, there is a decrease in ________ (3 things) as the ______ is activated |
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Definition
1. decrease in CO
2. decrease BP
3. decreased renal blood flow
RAAS is activated |
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Term
| as there is continued peripheral vasoconstriction, there is _____ absorption of sodium and water |
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Definition
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Term
| Some examples of neurohormonal changes |
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Definition
| increased sodium retention, increased thirst, increased afterload d/t vasoconstriction, destoyed cardiac myocytes, arrhythmias |
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Term
| ANP and BNP (what are they and what do they do?) |
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Definition
atriatic neuropeptide and B type neuropeptide
they increase natriuresis and diuresis, balances vasoconstriction, and is less potent than other neurohormones causing sodium and water retention |
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Term
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Definition
| weight gain, nocturia (d/t inc. kidney perfusion), gi complaints like bloating, rales, edema, JVD, ascites, elevated liver fxn tests, S3 sound heard, cough, dyspnea, orthopnea (harder to breath laying down) |
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Term
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Definition
| fatigue/weakness, SOB/orthopnea, anxiety/agiation (d/t release of epi and NE), decreased UO (low kidney perfusion), severe lightheadedness, general discomfort d/t low skin perfusion, hypotension, tachycardia, worsening labs (BUN, creatinine, hyponatremia), Cheyne-stroke |
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Term
ACE INHIBITORS
-what are they used for
-how do they work |
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Definition
-first line drugs to stop RAAS and for patients with <40% EF (may be with or without symptoms)
- these drugs prevent conversion of angiotensin I to II and therefore decrease vasoconstriction by increasing vasodilation, which decreased the hearts workd load to overcome the pressure (afterload) when pumping blood out of heart |
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Term
| Examples of ACE Inhibitors |
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Definition
| Captopril, Enalapril, Lisinopril |
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Term
ARB's
-what are they
-what do they do |
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Definition
Angiotensin Receptor Blockers
-prevent angiotensin II from attaching to cell surface, therefore preventing vasoconstriction, so decrease afterload
-good for pt who can't take ACE inhibitors d/t to coughing or angioedemea (these cause less cough) |
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Term
| Side Effects of ACE Inhibitors |
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Definition
| hypotension, worsening kidney fxn, hyperkalemia, cough, angioedema (anaphylactic rxn to drug so stop drug immediately!) |
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Term
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Definition
| lightheadedness/dizzy, dec. kidney fxn, hyperkalemia, headache, cough |
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Term
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Definition
| Candesartan, Losartan, Valsartan |
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Term
Vasodilators
-what do they do
-side efx
-good for who? |
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Definition
-they will reduce elevated pressures (afterload and/or preload!)
-hypotension, HA, nausea
-good, esp. in combo therapy, for those who can't take ACEI d/t too much hypotension or renal insufficiency |
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Term
Digoxin
-what is it
-what does it do
-how do you dose it
-sx of overdose |
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Definition
-its an oral inotrope
-decreases HR, sx, and hospitalization (does NOT help them live longer!!!)
-keep dig level between 0.5-1.5 ng/ml
-GI complaints, confusion, fatigue, halo vision, bradycardia |
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