Heart Failure Overview

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Questions and Answers

What is a recommended dietary restriction for patients taking diuretics and ACE inhibitors?

  • Increase intake of dairy products
  • Increase protein intake
  • Restrict dietary sodium (correct)
  • Restrict dietary potassium

Which of the following symptoms is most commonly associated with mitral stenosis?

  • Dry cough (correct)
  • Weight gain
  • Palpitations
  • Chest pain

What is a key complication following mitral valve surgery?

  • Decreased respiratory rate
  • Development of arrhythmias (correct)
  • Improved blood viscosity
  • Increased cardiac output

What should be closely monitored in patients taking potassium-sparing diuretics?

<p>Renal function (B)</p> Signup and view all the answers

Which of the following is NOT a typical symptom of mitral regurgitation?

<p>Nausea (A)</p> Signup and view all the answers

In individuals with aortic stenosis, what is the primary consequence of the obstructed outflow?

<p>Decreased stroke volume (D)</p> Signup and view all the answers

Which of the following can be a home care resource for managing heart failure?

<p>Home care nurse (C)</p> Signup and view all the answers

Mitral valve prolapse is most commonly associated with which condition?

<p>Marfan syndrome (C)</p> Signup and view all the answers

What is the primary characteristic of systolic heart failure?

<p>Inability of the heart to contract forcefully enough (A)</p> Signup and view all the answers

Which drug is commonly used to increase contractility in chronic heart failure patients?

<p>Digoxin (B)</p> Signup and view all the answers

What should be monitored before administering potassium in patients with heart failure?

<p>Serum creatinine levels above 1.8 mg/dL (C)</p> Signup and view all the answers

Which treatment modality can help improve cardiac output and ejection fraction in patients with obstructive sleep apnea?

<p>CPAP (B)</p> Signup and view all the answers

What is a possible consequence of decreased ejection fraction in heart failure?

<p>Accumulation of blood in pulmonary vessels (D)</p> Signup and view all the answers

Which of the following describes a typical symptom of heart failure?

<p>Persistent dyspnea (D)</p> Signup and view all the answers

What is the purpose of Cardiac Resynchronization Therapy (CRT) in heart failure management?

<p>To enhance synchronization of ventricle contractions (A)</p> Signup and view all the answers

Which is a possible side effect of Digoxin toxicity in heart failure patients?

<p>Blurred vision (C)</p> Signup and view all the answers

Which strategy is crucial for maintaining cardiac output in patients with atrial fibrillation and valvular heart disease?

<p>Implementing low-dose amiodarone therapy (D)</p> Signup and view all the answers

What is one of the primary complications associated with valvular heart disease that needs to be monitored?

<p>Decreased CO leading to heart failure (D)</p> Signup and view all the answers

In managing pulmonary edema, which medication is generally used as part of the nonsurgical approach?

<p>Diuretics (B)</p> Signup and view all the answers

Which of the following statements about drug therapy for heart failure is true?

<p>Beta-blockers can help improve heart function over time. (B)</p> Signup and view all the answers

What is the purpose of balloon valvuloplasty in patients with valvular heart disease?

<p>To perform a non-surgical repair of a stenotic valve (A)</p> Signup and view all the answers

Which condition is commonly connected with aortic regurgitation and should be assessed?

<p>Marfan syndrome (C)</p> Signup and view all the answers

When should prophylactic antibiotic therapy be considered in patients with valvular heart disease?

<p>Before dental surgery (C)</p> Signup and view all the answers

Which type of murmur is typically associated with aortic stenosis?

<p>Diamond-shaped systolic crescendo-decrescendo murmur (C)</p> Signup and view all the answers

Flashcards

Serum Potassium Monitoring

Regular blood tests to check potassium levels in patients taking diuretics and certain heart medications (ACE inhibitors, ARBs, Sacubitril/Valsartan, potassium-sparing diuretics).

Mitral Stenosis Cause

Usually caused by rheumatic carditis, a condition that thickens and stiffens the heart valve leaflets.

Mitral Valve Prolapse

A condition where the heart valve leaflets enlarge and bulge into the left atrium during a heartbeat's pumping phase.

Mitral Regurgitation

Inability of the mitral valve to completely close during heart pumping, causing blood to leak back into the left atrium.

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Symptoms of Mitral Regurgitation

Symptoms gradually appear when the heart struggles to pump effectively, including fatigue, weakness, shortness of breath, and chest pain.

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Aortic Stenosis

The narrowing of the aortic valve, the primary valve controlling blood flow from the heart to the body.

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High-Sodium Diet Restriction

Limiting sodium intake to prevent fluid retention and blood pressure issues.

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Sudden Cardiac Death Risk in Heart Failure

Heart failure is associated with a higher risk of sudden death, thus the importance of assessing Advance Directives in patients with this condition.

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Aortic Stenosis Cause

Narrowing of the aortic valve opening, often due to congenital bicuspid or unicuspid valves.

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Aortic Stenosis Symptoms

Dyspnea (shortness of breath), angina (chest pain), syncope (fainting) on exertion, fatigue, and cyanosis.

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Aortic Regurgitation Cause

Aortic valve doesn't close properly, allowing blood to flow backward into the left ventricle during diastole.

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Aortic Regurgitation Symptoms

Bounding pulse, widened pulse pressure, diastolic murmur, shortness of breath.

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LV Hypertrophy (Both conditions)

Left ventricle thickens in response to increased workload from restricted or leaking aortic valve.

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Aortic Valve Assessment

Examination for family history of heart conditions, signs of infections, and vital signs like pulse.

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Valve Diagnosis Methods (Aortic)

Methods like echocardiography to visualize heart valve structure and movement are used.

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Maintaining Cardiac Output

Vital in valve disease, especially when atrial fibrillation develops; medication may be needed to support.

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What is heart failure?

A condition where the heart can't pump blood effectively throughout the body. It's like a weakened pump struggling to keep up with demand.

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What's left-sided heart failure (LHF)?

The left ventricle, responsible for pumping oxygenated blood to the body, weakens and struggles to maintain adequate blood flow.

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What's right-sided heart failure (RHF)?

The right ventricle, responsible for pumping deoxygenated blood to the lungs, weakens and struggles to effectively pump blood to the lungs.

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What is ejection fraction (EF)?

The percentage of blood ejected from the left ventricle during each heartbeat. It measures how effectively the heart pumps.

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What is systolic heart failure?

A type of heart failure characterized by a weakened left ventricle, resulting in a low ejection fraction and reduced blood output.

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What is the relationship between heart failure and EF?

Heart failure often leads to a reduced EF, as the weakened heart struggles to pump out an adequate amount of blood.

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How does decreased EF affect the body?

Reduced EF can decrease tissue perfusion (blood flow to tissues) and cause blood to accumulate in pulmonary vessels, leading to congestion.

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What are some signs of heart failure?

Shortness of breath, fatigue, swelling in the legs and ankles, and weight gain are common signs of heart failure.

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Study Notes

Heart Failure (HF)

  • HF - aka pump failure, inability of the heart to effectively pump blood.
  • Major types:
    • Left-sided heart failure (LHF)
    • Right-sided heart failure (RHF)
    • High-output failure (HOF)
  • Most HF begins with LV failure, affecting both ventricles.
  • Systolic HF - HF with ejection fraction, where the heart can't contract forcefully.
  • Ejection Fraction (EF): Percentage of blood ejected from the ventricles during systole. A normal EF is 50%-70%, but drops to 40% with dilation. Decrease in EF indicates forward failure because CO is reduced and fluid backs up in the pulmonary system.
  • Diastolic HF (HFpEF) - HF with preserved ejection fraction, where the ventricle can't relax during diastole. The ventricle stiffens, preventing it from filling properly with sufficient blood to ensure adequate cardiac output (CO).
  • Right-sided HF is caused by LHF, RV MI, cardiomyopathy, pulmonic valvular disease, or pulmonary hypertension.
  • High-output HF - CO remains normal/above normal due to metabolic needs or hyperkinetic conditions (infection, fever, anemia, hyperthyroidism).

Systolic HF Subtypes

  • EF <30%: Implantable Cardioverter-Defibrillator (ICD) may be needed.
  • Symptoms of inadequate tissue perfusion or pulm/systemic congestion. Includes dyspnea, weakness, fatigue, dizziness, and acute confusion.

High-Output HF

  • CO above normal, caused by increased metabolic demands.
  • Common causes include infection, fever, anemia, or hyperthyroidism.

Classification/Staging

  • Class I-IV NYHA (New York Heart Association) classification based on symptoms, not structural abnormalities.

Compensatory Mechanisms

  • SNS stimulation (catecholamines) results from tissue hypoxia, causing immediate increase in heart rate (HR) and blood pressure (BP) due to vasoconstriction.
  • Other compensatory mechanisms assist with maintaining CO, but eventually lead to impaired function over time.

Additional Key Factors

  • Impaired renal function leads to increased BUN and serum creatinine levels, with decreased creatinine clearance.
  • Hypoxia can occur from reduced cardiac output.
  • Dysrhythmias, structural heart changes, valvular dysfunction, or other cardiac infections can contribute to HF.
  • Electrolyte imbalances can result from fluid retention.
  • Laboratory tests (BNP, HCT/HGB) can be used to help diagnosis.

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