Heart Failure: Terms, Definitions, and Manifestations, Quizzes of Auditing

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TERM 1 Heart Failure DEFINITION 1 Inability of the heart to pump sufficient blood to meet the demand of the body Hallmark is exercise intolerance Most cases are related to MI and chronic HTN TERM 2 Clinical Manifestations of Chronic heart failure DEFINITION 2 Fatigue Dyspnea/orthopnea Tachycardia Nocturia Chest pain PND Edema-- weight changes secondary to fluid retention Behavioral changes TERM 3 Causes LV failure DEFINITION 3 HTN CAD Vascular disease TERM 4 Causes RV failure DEFINITION 4 LV failure RV infarct Pulmonary HTN TERM 5 Bi-ventricular Failure DEFINITION 5 Usually RV failure secondary to LV failure TERM 6 Acute Heart Failure DEFINITION 6 Generally LV failure, following a large acute MI TERM 7 Chronic Heart Failure DEFINITION 7 Persisted over 6 months TERM 8 Systolic Dysfunction DEFINITION 8 Reduced Ejection fraction Heart can't pump enough TERM 9 Diastolic Dysfunction DEFINITION 9 Heart not adequately filling (decreased filling) May still pump enough, but not enough volume TERM 10 Low output failure DEFINITION 10 Weak myocardial muscle can't pump enough TERM 21 Pulmonary Edema DEFINITION 21 Will have serious diffuse crackes, cannot breath, diaphoretic, sitting forward IV diuretics Morphine sulfate Nitroglycerine Nitroprusside High Fowler's position Oxygen-- highest level patient can tolerate Foley Catheter TERM 22 Rheumatic Carditis DEFINITION 22 Affects 40% of patients with RF Get RF group beta-hemolytic streptococci (3% develop without antibiotics RC) Impairs pumping function, muscle tissue, pericardium and valves (scar tissue) TERM 23 Valvular heart Disease DEFINITION 23 Congenital or acquired valvular dysfunctions Valvular stenosis (kitchen doors don't swing all the way open) Valvular Insufficiency/Regurgitation (Kitchen doors don't close all the way) TERM 24 Most common acquired valvular dysfunctions DEFINITION 24 Mitral stenosis Mitral Regurgitation Mitral valve prolapse Aortic Stenosis Aortic regurgitation TERM 25 Mitral Stenosis DEFINITION 25 Usually following rheumatic carditis Valve is thickened by fibrosis and calcification SX: DOE, fatigue, orthopnea, neck vein distension Heard at apical area on diastole. Sounds like turbulence instead of lub dup-- hear lub swoosh Murmurs graded on 1- 6 scale (1 hard to hear, 6 might hear without steth) TERM 26 Mitral Regurgitation (Insufficiency) DEFINITION 26 Caused by rheumatic heart disease LA and LV dilate and hypertrophy May be symptom free for decades; common complaints are anxiety, chest pain and palpitations Fatigue and weakness, followed by DOE and orthopnea Systolic murmur heard in the apical area TERM 27 Mitral Valve Prolapse DEFINITION 27 Valvular leaflets enlarge and prolapse into the LA during systole Usually benign and asymptomatic PE: Systolic click Familial occurence often found Associated with Marfan's syndrome (very long armspan, tall, skinny, visual problems, cardiac dz) Most common in young to middle aged women TERM 28 Aortic Stenosis DEFINITION 28 Increased resistance to ejection during systole, leading to LV failure and eventually RV failure Sx: Dyspnea, angina, syncope PE: systolic crescendo/ decrescendo murmur Most common valvular disorder in aging population (atherosclerosis) majority are men Valvular malformation or RHD in pts <70 Systolic murmur heart @ 2nd IC space on right sternal border TERM 29 Aortic Regurgitation (Insufficiency) DEFINITION 29 Creates dilation of LV Asymptomatic for many years before sx of LV failure occur Usually from non-RHD: endocarditis, congenital, HTN, Marfan's syndrome; majority are men Sx: DOE, orthopnea, PND Diastolic murmur at 2nd IC space on the right sternal border TERM 30 Cardiomyopathy DEFINITION 30 Enlarged cardiac muscle; decreased pumping Often has unknown etiology; may be ETOH ~50% of patients die in 5 years Viral syndromes can precede and cause cardiomyopathy Can cause heart failure dilated, hypertrophic, restrictive TERM 31 Hypertrophic cardiomyopathy DEFINITION 31 LV hypertrophy with obstruction in LV outflow Abnormal stiffness of LV HCM is genetic in 50% of cases (autosomal dominant trait) Often a cause of sudden death in young athletes Atrial fibrillation important to look at family history is pt has fainted or has family members with HCM TERM 32 Restrictive Cardiomyopathy DEFINITION 32 Rarest CM LV filling is restricted Dyspnea, fatigue, right sided HF Gallop rhythms (?) TERM 33 Tx cardiomyopathy DEFINITION 33 Implantable defibrillator Medications Mgmt heart failure Improve activity levels TERM 34 Infective Endocarditis DEFINITION 34 Infection of the valves and endothelial surface of the heart caused by direct invasion by bacteria (defect in heart harbors microbes) Usually r/t valve replacements, structural cardiac defects or IV drug abuse Sources of infection; oral cavity, skin lesions, infections, invasive procedures Look at high risk pts and take preventative measures ie: prophylactic antibiotic use before dental procedures for pts with valve problems TERM 35 Infective Endocarditis complaints/ s/sx DEFINITION 35 Pt c/o chills, fever, flu sx New onset murmur in 90% Osler's nodes and Janeway's lesions (hemorrhagic lesions on fingers, hands, toes) Petechiae (mouth, eyes, chest) Splinter hemorrhages (nail beds) Arterial embolic complications (50%) r/t fragments of vegetatio: spleen, kidneys, mesenteric, CNS, lung