CHF

Question 1

Heart failure:

Answer 1

The heart is not pumping well enough to meet body’s demand for oxygen

Question 2

Decreased heart ________ means that the heart has to work ______ to try to make up for the __________ in function.

Answer 2

efficiency
harder
shortcoming

Question 3

Causes:

Answer 3

• CAD/ Atherosclerosis
• Lt ventricle damage or dysfunction/ Lt ventricular hypokinesis ( LT ventricle is the major pumping station to the body) Secondary to MI or multiple MI’s, systolic dysfunction, alcohol abuse
• Rt heart failure/ Cor pulmonale: long term HTN in the pulmonary arteries & Rt ventricle of the heart: associated with COPD or pulmonary decease : When the Rt side of heart cannot generate enough force to pump blood through diseased lungs
• Cardiomyopathy: weakening of the heart mm
• Congenital heart disease: birth defects that give rise to heart problems; multiple disorders
• Valvular heart Disease:
• Chronic hypertension:

Question 4

Valvular heart disease:

Answer 4

Stenosis, regurgitation; valvular endocardities-confined to the endocardium of the heart valves; rheumatic heart disease-inflammatory disease following streptococcus progenies infection, bacterial.

Question 5

Lt ventricle damage or dysfunction:

Answer 5

Lt ventricular hypokinesis; Lt ventricle is the major pumping station of the body
-Secondary to MI or multiple MI’s systolic dysfunction, alcohol abuse

Question 6

Rt heart failure/ Cor pulmonale:

Answer 6

Long term HTN in the pulmonary arteries and Rt ventricle of the heart

• Associated with COPD or pulmonary disease
• When the Rt side of the heart cannot generate enough force to pump blood through diseased lungs.

Question 7

OTher contributing factors:

Answer 7

• Diabetes
• Lpus: leads to long term, chronic inflammation
• RA: chronic disease that leads to inflammation of the joints and surrounding tissues
• Hyper or hypo thyroidism: leads to unstable chemical reactions in the body; increased LDL
• Alcohol abuse
• Drug abuse; amphetamines, cocaine
• Bacterial or viral infections

Question 8

Risk factors:

Answer 8

• Smoking
• Obesity
• Sedentary life style; lack of exercise
• Poor dietary habits: high salt intake
• Uncontrolled HTN
• Prolonged high emotional stress.

Question 9

Signs and Symptoms:

Answer 9

• Pulmonary edema: fluid buildup in the interstitial space of the lungs with rales.
• Peripheral edema with rapid weight gain
• Tachycardia/arrhythmias
• Decreased peripheral blood flow
• Pre-renal failure progressing to kidney failure
• Increased fatigue at lower levels of activity.
• Dyspnea/ orthopena/ paroxysmal sudden Nocturnal dyspnea
• Crackles, wheezing, coughing
• Hypoxia/cyanosis or pallor
• Presence of s3 heart sounds: 3rd heart sound associated with heart failure (ken tuck- ky represents 3rd sound)
• possible heart murmurs, esp. with a valve-related disorder: mitral regurgitation
• Swollen neck veins
• Mental confusion
• Enlarged heart/ Cardiomegaly
• Decreased pedal pulses

Question 10

Diagnostic test to confirm CHF:

Answer 10

• EKG: ECG: electrocardiogram, line graph of heart condition
• Chest X-ray
• Pulmonary artery monitoring elevated pressure
• Echocardiogram: sound waves to produce heart images
• Exercise tolerance (stress Test (ETT)
• Blood tests
• Radionuclide imagin
• Coronary angiogram:

Question 11

Blood tests:

Answer 11

Albumin levels to detect elevated levels indicated CHF

-B- type natriuretic peptide (BNP) is a protein that is produced by the heart as it fails.

Question 12

Radionuclide Imaging:

Answer 12

Infected into tissues/ MRI; radionuclide ventriculogram, injected material can be viewed circulating the heart

Question 13

Coronary angiogram:

Answer 13

-ray images of the hearts blood vessels

Question 14

Treatment for CHF:

Answer 14

• Limit activity until cleared by MD, initiate cardiac rehab program
• progress slowly, especially if pt is very limited initially
• Monitor signs of peripheral edema
• Red Flags
• Angioplasty:
• Pacemaker to treat bradycardia if present
• Heart transplant is most severe cases

Question 15

Red Flags:

Answer 15

• Shoes, belt or pants become too tight to fasten
• Normal activities become more difficult
• Pt begins to need more sleep than usual
• urination becomes more frequent at night
• Decreasing BP over time
• Flat or decreasing systolic BP with increasing activity

Question 16

Angioplasty:

Answer 16

Stenting or CABG for CAD if present