533 Exam 4:Questions & Answers
Universal stages of Heart Failure (HF) - ANSWER:- At-risk for HF
- Pre HF
- HF
- Advanced HF
according to the universal definition, what is "at-risk for HF"? - ANSWER:- do not have HF, but at risk
- no current or prior s/s
- no structural, functional, or biomarker evidence supporting HF
according to the universal definition, what is "HF" - ANSWER:- clinical syndrome
- current or prior s/s of HF
- caused by structural of functional cardiac abnormality
- elevated natriuretic peptide levels
- evidence of pulmonary or systemic congestion
who is most at risk for HF - ANSWER:black males and females; older women
two biggest causes of HF - ANSWER:1. ischemic heart disease (CAD)
2. HTN
calculate EF - ANSWER:SV/LVEDV
synonym for inotropy - ANSWER:contraction (HFrEF)
synonym for lusitropy - ANSWER:relaxation (HFpEF)
two organizations for classification of HF - ANSWER:1. American Heart Assocation (A,B,C,D) - based on
structure
2. New York Heart Association (None, I, I, II, III, IV, V) - based on physical activity limitations
how to distinguish cardiac dysfunction versus cardiac HF - ANSWER:cardiac dysfunction has structural
abnormalities w/o symptoms
once a patient develops symptoms along with structural abnormalities, they have HF
compensatory mechanisms for HF - ANSWER:1. Hemodynamics (Frank Starling Law) - can give inotropes
as short term use to increase contractility (long-term can cause mortality)
, 2. SNS activation (increase contractility, tachycardia, vasoconstriction)
3. RAAS activation (angiotensin II binds to AT 1 Receptor - vasoconstriction)
two types of angiotensin II - ANSWER:1. circulating
2. tissue-derived
effects of circulating angiotensin II on HF - ANSWER:- causes vasoconstriction
- increases secretion of ADH
- increase aldosterone secretion
- increases sodium reabsorption
are aldosterone levels high or low in HF? - ANSWER:20x higher than normal
effects of aldosterone on HF - ANSWER:- increases sodium and water reabsorption
- decreased potassium and magnesium
- decreased baroreceptor reflex
- sympathetic activation
list the comprehensive risk factors of Coronary Artery Disease - ANSWER:- dyslipidemia
- genetic studies
- modifiable risk factors
- non-modifiable risk factors
- novel risk factors
what are two classes of medications an individual with HFrEF will be started on? - ANSWER:1. beta
blocker (to counter SNS)
2. ACEi (to counter RAAS)
what hormones worsen HF - ANSWER:- Angiontensin II (RAAS)
- catecholamines (SNS)
- endothelin
- aldosterone
hormones that are good for HF - ANSWER:- natriuretic peptides (ANP, BNP, CNP)
- adrenmedullin