Failure (HF) - Answers-Inability of ventricles to pump enough blood for body's needs
-Weakening of heart muscle due to aging or disease
Diseases Associated with Heart Failure - AnswersCoronary artery disease (C A D)
Mitral stenosis
Myocardial infarction (M I)
Chronic H T N
Diabetes Mellitus
Cure for Heart Failure - AnswersNo cure, only prevention and slowing of progression
Left-Sided Heart Failure - Answers-Blood accumulates in left ventricle
-Left ventricle thickens and enlarges: hypertrophy
-Cardiac remodeling
Blood backs up into lungs
-Cough and shortness of breath result
Right-Sided Heart Failure - Answers-Blood backs up into veins
-Causes peripheral edema and organ engorgement
-Less common than left-sided H F
Preload - Answers-The degree myocardial fibers are stretched prior to contraction
-Affects cardiac output
Frank-Starling law: Associated with Preload - AnswersMore fibers are stretched, more forcefully
they will contract
Positive inotropic agents - AnswersDrug that increases preload contractility resulting in
increased cardiac output
Afterload - Answers-Pressure in aorta that must be overcome before blood is ejected from left
ventricle
, -Lowering blood pressure creates less afterload, resulting in less workload for the heart
-Affects cardiac output
Pharmacologic Management of Heart Failure - Answers-Slowing the heart rate
-Increasing contractility
-Reducing myocardial workload
Lisinopril (Prinivil, Zestril)- ACE inhibitors and Angiotensin Receptor Blocker: ADVERSE EFFECTS -
AnswersSevere hypotension (first dose phenomenon) syncope, blood dyscrasias, angioedema,
fetal toxicity
Digoxin- Adverse Effects (Cardiac Glycoside) - AnswersDysrhymias, Atrioventricular Block
Non-Underlined:
Nausea, vomiting, headache and visual disturbances such as seeing halos, a yellow- green tinge
or blurring
Milrinone (Primacor) - AnswersDysrhythmias
Headache, hypotension
ACE Inhibitors - Answers-Reduce afterload
-Drug of choice for heart failure
-Enhance excretion of sodium and water
-Lowers peripheral resistance and reduces blood volume
-Increases cardiac output
Angiotensin II Receptor Blockers (ARBs) - Answers-Actions very similar to ACE inhibitors
-Usually used for patients who are unable to tolerate the adverse effects of ACE inhibitors
Diuretics - Answers-Increase urine flow
-Reduce blood volume and cardiac workload
-Reduce edema and pulmonary congestion