HEART FAILURE - level 4 - exam 1

HEART FAILURE - level 4 - exam 1

U Upright Position
N Nitrates
L Lasix
O Oxygen
A Amiodorone, ACE, ARBs
D Dig, Dobutamine
M Morphine Sulfate
E Extremities Up or Down Correct answer- HEART FAILURE PNEUMONIC

DEFINITION Correct answer- *CO=SV X HR IS INSUFFICIENT TO MEET THE
METABOLIC NEEDS OF THE BODY*

SV IS DETERMINED BY PRELOAD, AFTERLOAD AND MYOCARDIAL
CONTRACTILITY

SYSTOLIC FAILURE- DEC. CONTRACTILITY- WEAK PUMP

DIASTOLIC FAILURE- DEC. FILLING

*EF< 40%*

volume of blood in the ventricles at the end of diastole. *It determines the amount of
stretch.*
=End diastolic volume Correct answer- preload

peripheral resistance against which the left vent must pump. It is affected by size of
vent, wall tension and BP. It determines the amount of squeeze.
=End systolic wall stress (resistance) Correct answer- afterload

amount of blood pumped by each vent in 1 min.
N=4-8L Correct answer- CO

cardiac ________________ is the CO/body surface area.
N=2.8-4.2 Correct answer- index

(SBP + 2DBP)/3 = ___________
average pressure within the arterial system felt by the organs. It determines amount of
perfusion to the organs. N=>60
<60=ischemia Correct answer- MAP

,HF pneumonic: UNLOAD ME
What does UNLOAD stand for?
U= ______________ position
N
L
O
A = _______________, ACE, ARBs
D= ________________, dobutamine Correct answer- upright
nitrates
lasix
oxygen
amiodarone
dig

HF pneumonic: UNLOAD ME
What does ME stand for?
M
E___________________ up or down Correct answer- Morphine
Extremities

Inotrope refers to the force of _________________ Correct answer- contraction

chronotrope refers to the ____________ of the heart Correct answer- rate

Sitting upright (decreases/increases) preload by decreasing venous return Correct
answer- decreases

Nitrates (decrease/increase) afterload and preload by venous dilation Correct answer-
decrease

Lasix and morphine (decrease/increase) preload Correct answer- decrease

heart is insufficient in meeting the metabolic needs of the body is called
_________________ __________________. EF<40% is also an indicator. Correct
answer- heart failure

Compensatory mechanism known as _____________________ ______________:
Enlargement of the chambers of the heart that occurs when pressure in the left vent is
elevated.
Initially it's effective but eventually it becomes inadequate and CO decreases. Correct
answer- starling's law

HF: End result of all compensatory mechanisms: (2) Correct answer- fluid overload
edema

, When O2 demand is more than the supply, cardiac walls thicken due to increase in
muscle mass.

INITIALLY EFFECTIVE

Eventually this leads to poor contractility, increased O2 needs, poor coronary artery
circulation and risk for vent dysrhythmias.

*What is this called?* Correct answer- hypertrophy

#1 cause of heart failure
Others include: CAD, MI
DM, age, tobacco, obesity
African American, valvular disease
hypervolemia, cardiomyopathy
alcohol, pulm htn Correct answer- htn

CAUSES OF HEART FAILURE "FAILURE" Correct answer- FAULTY HEART VALVES

ARRHYTHMIAS- AFIB OR TACHYCARDIA

INFECTION- (ENDOCARIDITIS)

LINEAGE- OBESITY, CONGENITAL OR ELDERLY, DIABETES, AFRICAN AMERICAN

*UNCONTROLLED HYPERTENSION*

* CORONARY ARTERY DISEASE, MI*

RECREATIONAL DRUGS INCLUDING ALCOHOL AND TOBACCO

EVADERS- VIRUSES (MYOCARDITIS)

Most common class of hf: (systolic/diastolic/mixed)
Hallmark finding is decrease in left vent ef.
*WRITTEN AS HFrEF*
<40-10

Caused by:
-Impaired contractility-- from MI)
-Increased afterload--HYPERTENSION
-cardiomyopathy
-mechanical abnormalities--VALVE DISEASE Correct answer- systolic

SV/EDV = ?
SV x HR = ? Correct answer- EF