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## CAP Syndrome - Can affect either the left or the right side of the heart - Unable to function as a pump - Myocardial deficiency - Workload pressure - Volume ### Presentation #### Left-sided - From lungs to body - Oxygenated blood - Pulmonary congestion - Pale, cyanotic skin - Shortnes...

## CAP Syndrome - Can affect either the left or the right side of the heart - Unable to function as a pump - Myocardial deficiency - Workload pressure - Volume ### Presentation #### Left-sided - From lungs to body - Oxygenated blood - Pulmonary congestion - Pale, cyanotic skin - Shortness of breath, crackles #### Right-sided - From body to lungs - Deoxygenated blood - Systemic congestion - Cold, clammy skin, cyanotic - Fluid accumulation - Jugular venous distention (JVD) - Gravity is a factor ## NY Heart Association Classification: - X4 - The bigger the worse. ## Drug Therapy - **Inotropic:** Increases the force of heart contraction - **Chronotropic:** Increases heart rate - **Dromotropic:** Increases the speed of conduction through the AV node ### Classes of Medications 1. **ACE inhibitors** 2. **Angiotensin II receptor blockers** - No cough 3. **Certain B-blockers** 4. **Loop diuretics** (`furosemide`) - No retention - Edema 5. **Aldosterone inhibitors** - No retention - Edema (`spironolactone`, `eplerenone (Fripia)`) 6. **Digoxin** - After all others were used only - Increases inotropic effect, many adverse effects - **K-spiring**- Symptoms of hyperkalemia - **4-block** - Beta blocker receptor