1. Heart failure - - The ventricles have difficulty filling with b...

NUR 325 Week 9

• Heart failure

Answer

• Heart failure is associated with ventricular dysfunction (usually involves both ventricles)

• The ventricles have difficulty filling with blood/relaxation (diastole) and/ or contracting

(systole)

a) Used to be classified as systolic and diastolic HF

b) Also used to be called congestive HF Indicates there's always congestion w/ HF which isn't

true

• Heart failure can result in

Answer

• Decreased exercise tolerance

b/c heart isn't pumping effectively -> oxygen and nutrients aren't being delivered to the body

• Decreased QOL

Answer b/c it causes fatigue -> impacts ability to carry out ADLs

• Shortened life expectancy Is improving w/ new treatment

• Heart failure etiology

Answer Top 2

• Hypertension

• Coronary artery disease

makes it more difficult to deliver O2 and nutrients -> weakens the heart muscle 1 / 3

Others

• Myocardial infarction

Answer part of the myocardium has died -> weaker heart

• Valvular heart disease

• Cardiomyopathy

Answer disease of heart muscle

• Valvular heart disease and HF

Answer Regurgitation of the valves (not all the blood gets through b/c of backflow, which makes extra work for the hard to pump) or valvular stenosis (narrowed valve -> harder for blood to get through)

• Hypertension and HF

Answer

• Increased pressure throughout arteries -> heart has to pump harder against that pressure

• Also the biggest cause of left ventricular hypertrophy (thickened left ventricle wall b/c the

myocytes have hypertrophied b/c they've been working harder)

• Risk factors for heart failure

Answer

• Diabetes

relationship between insulin resistance and ventricular hypertrophy

• Also increases risk for CAD and hypertension
• Smoking 2 / 3

• Obesity

• Dyslipidemia

Answer high cholesterol levels

• Ejection fraction

Answer

• EF = amount of blood pumped out by the left ventricle/amount of blood in chamber

• Compares the amount of blood in the heart to the amount of blood pumped out
• The fraction or percentages helps describe how well the heart is pumping blood to the body

• Heart failure classification

Answer

• Heart failure with preserved ejection fraction (HFpEF) = 50-70% pumped out during each

contraction + symptoms of HF

• 50-70% EF is normal but when symptoms occur, this means that there's a problem with the

ventricle relaxing (not relaxing enough for blood to be effectively pumped out)

• Heart failure with reduced ejection fraction (HFrEF) = d40% is pumped out during each

contraction (symptoms may become noticeable even during rest)

• Heart failure w/ a mid-range ejection fraction (HFmEF)

Answer 41-49% pumped out during each contraction

• On their way to developing reduced or preserved EF

• HF compensatory mechanisms

Answer

• HF results in decreased CO, decreased BP, decreased SV

• The heart tries to compensate through
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