Heart Failure 1
The heart is unable to pump blood well enough to meet the needs of the body.
Heart Failure
Most common, formerly referred to as Congestive Heart Failure.
Can be acute/chronic, mild/severe.
Systolic Heart Failure
Diastolic Heart Failure
Left-Sided Heart Failure
Enhances Contractibility
Blocks the effects of adrenaline, decreased the hearts workload. Lowers BP and HR.
CAN'T stop abruptly, can cause rebound HTN=risk for attack or stroke. Need to taper dose.
S/E: weakness, fatigue, low HR and BP
Can determine the shape of the heart.
Chest X-ray
Microbial infection involving the endocardium.
Diagnostic assessment: (+) blood cultures, new regurgitant murmur, evidence of endocardial involvement by echocardiography.
Infective Endocarditis
The most effective treatments is a combination of ....
Medication, low sodium diet, and exercise
Heart can't pump enough blood to the tissues due to age, LSHF, COPD, pulmonary HTN, or valve disease.
Fluid backs up in the liver, GI tract and limbs.
S/S: SOB, swelling of feet, ankles, abdomen, nocturia, pronounced neck veins, palpitations, irregular HR, fatigue, weakness and fainting.
Right-Sided Heart Failure
Reduce Afterload
Monitor K supplements and K sparing diuretics.
Watch carefully with COPD patients.
S/E: tickling cough, kidney problems, facial swelling, dizziness, weakness, low BP
Ace Inhibitors
Shows an electrical tracing of heart rhythm which can show dysrhythmias, myocardial injury, ischemia or infarction.
Electrocardiogram
Includes: mitral stenosis, mitral regurgitation, mitral valve prolapse, aortic stenosis, aortic regurgitation.
Sudden illness or slowly developing symptoms over many years.
Valvular Heart Disease
Heart can't contract forcefully enough during systole to eject adequate amounts of blood.
Reduced EF: Less than 40%
Systolic Heart Failure
The cause of heart failure in most cases.
Systemic HTN
Reduce Afterload
Only used if unable to tolerate another medication. CAN'T use during pregnancy.
S/E: low BP, dizziness, weakness, diarrhea, kidney problems.
Angiotensin II Receptor Blockers (ARBs)
Shows the valves, chamber enlargement, hypertrophy, and ejection fraction.
Echocardiogram
Subacute or chronic disease of cardiac muscle.
Drug therapy: diuretics, vasodilating agents, cardiac glycosides (Digoxin).
Cardiomyopathy
Caused by ventricular failure, right ventricular MI or pulmonary HTN.
Right ventricle can't empty properly.
Increased volume and pressure develops in the venous system and results in peripheral edema.
Right-Sided Heart Failure
Left ventricle can't relax adequately during diastole. This stiffening prevents the ventricle from filling to ensure an adequate cardiac output.
EF: Greater than 40%
The ventricle becomes less compliant overtime R/T chronic HTN and untreated CAD.
Diastolic Heart Failure
Works to decrease water retention.
Blocks the effect of a stress hormone.
Decreases risk for dysrhythmias.
S/E: high potassium, weakness, fatigue, breast enlargement (esp. in men)
Aldosterone Antagonists
Pulmonary artery pressure (PAP) and pulmonary artery wedge pressure (PAWP) are elevated in left-sided heart failure.
The rarest kind of restrictive cardiomyopathy.
Restrictive Cardiomyopathy
Heart can't pump enough blood to the tissues due to age, HTN, CAD, cardiomyopathy, or heart attack.
Blood backs up in the lungs.
S/S: SOB, pink/white tinged sputum, pulmonary edema, crackles or rhonchi.
Left Sided Heart Failure
Not Common
Cardiac output is compromised. The patients individual condition requires increased metabolic needs (such as sepsis, high fever, anemia, or hyperthyroidism
Something else is going on and the heart can't meet the demands.
High-Output Cardiac Failure
Enhances Contractibility
Helps heart pump more efficiently, HCP may choose this medication if pt has an irregular or fast HR.
Must check apical HR before administration, hold if less than 60
Must check levels every 3 months for toxicity
Digoxin (Lanoxin)
The best tool to evaluate heart failure.
Echocardiogram
Most common type of cardiomyopathy
Causes: alcohol abuse, chemotherapy, infection, poor nutrition.
Dilated Cardiomyopathy