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HF (Labs/diagnostics, Pathophysiology/causes, Risk factors, Symptoms,…
HF
Labs/diagnostics
ECG
chest X-ray
cardiomyopathies
serum electrolyte
BUN:creatine
BNP
.>100 pg/ml
ABGs
pH 7.4
pO2 75-100 mmHg
pCO2 35-45 mmHg
cardiac troponin
.>0.40 ng/ml
stress test
can help determine the severity
vitals
Pathophysiology/causes
HTN
Pathophysiology/causes
primary HYN
95% unknown
usually talk about risk factors
secondary HTN
5% of cases
renal artery stenosis
RAAS
aldestorne
resorbes sodium
resorbes water
vaso constriction
increases peripheral resistance
unilateral atrophy of affected kidney
cause
atherosclerosis
elderly males
fibromuscular dysplasia
young females
Symptoms
benign HTN
mild or moderate elevation of BP
clinically silent
vessels and organs are damaged overtime
Malignant HTN
severe increase in BP
.>200/120 mmHg
etiology
de novo
new
or from benign
acute renal failure
headache
papilledema
blurred vision
medical emergency
Risks
primary
age
older
race
african american males
high risk
asain males
low risk
Obesity
stress
high salt diet
low or no exercise
Labs/diagnostics
increase in plasma renin
bp
Complications/collaborative treatments
lifestyle changes
DIETARY RESTRICTION
LOW OR NO SALT DIETS
meds
ARBs
stress reduction techniques
ace inhibitors
diuretics
exercise
focusing on weight-loss
smoking cessation
increased blood pressure
.>140/90 mm Hg
25% OF US POPULATION
Congenital defects
Tetralogy of Fallot.
severe heart defect
missing interventricular septum
common in down syndrome
left sided heart failure
Myocardial infarctions
ischemia
cardiomyopathy
dilated
stretch the heart muscle
no longer contract as strong
restrictive
cant fill the heart appropriately
poor compliance of the heart muscle
hypertension
left heart has to pump harder against the high bp
heart muscle gets bigger and has more of a chance to infarct
cardiomyopathies
cocaine use
medications
genetic
arrythmias
carditis
inflammation
right sided heart failure
most often caused by left sided heart failure
cor pulmonale
copd
vasoconstriction due to hypoxia
left to right shunt
Risk factors
High BP
coronary artery disease
diabetes
MI
medication
nsaids
some anesthesia meds
meds to treat psychiatric disorders
cancer meds
infections
obstructive pulmonary disorders
asthma
bronchitis
bronchiectasis
enlargement of the bronchi
Symptoms
dyspnea
exertion
lyingdown
Nausea/vomiting
fatigue/weakness
fluid retention
weight gain
right sided
JVD
peripheral edema
dependent pitting
liver
ascistes
painful hepatospemagaly
enlargement of the liver
cardiac cirrhosis
liver cirrhosis as a result of the heart
left sided
pulmonary congestion
shortness of breath
crackles in lungs
Paroxysmal nocturnal dyspnea
dyspnea when pt lays flat over a period of hours
usually after sleep
orthopnea
dyspnea after laying down for a couple of minutes
heart failure cells
Hemosiderin laden macrophages
when the blood backs up into the lungs blood vessels may rupture
organs hypopersusion
cns
confusion
anxiety
loc
kidney
hypoperfusion
decrease gfr
pre renal azotemia
activiation of renin angiotensin aldosterone system
will increase bp
exacerbate HF
low bp
Complications/collaborative treatments
left sided
mainstay is ace inhibitors
surgery
heart valve replacement. repair
pacemaker
transplant
ventricular assistive devices
hospice
medications
beta-blockers
diuretics
digoxin
general definition
failure of the heart as a pump