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Heiman.pharm.CHF

Definitions and Pathophysiology

QuestionAnswer
Cardiac Output Volume of blood ejected from the heart per unit of time CO = SV X HR
Stroke Volume Volume of blood ejected with each beat
Afterload Force against which the ventricle must contract
Preload Amount of blood going to the heart
BP = CO X SVR (systemic vascular resistance)‏
Pathophysiology Usually originates with left – sided failure Decreased ability of ventricle to pump blood leads to Reflex sympathetic nervous system activation leads to Hypertension leads to Increased myocardial contractile strength
New York Heart Association (NYHA) Functional Classification Class I Asymptomatic at rest or with ordinary activity; signs or symptoms with severe exercise Class II Comfortable at rest; signs or symptoms with ordinary exercise
New York Heart Association (NYHA) Functional Classification Class III Comfortable at rest; signs or symptoms with mild or minimal exercise Class IV Signs or symptoms at rest
Common Precipitating Factors for Chronic Heart Failure Patient factors Alcohol intake Excessive fluid intake Excessive salt intake Increased stress Weight gain Progression of basic cause Hypertension Coronary artery disease
Common Precipitating Factors for Chronic Heart Failure Increased cardiac workload Arrhythmia Electrolyte and acid-base abnormalities Anemia, hypo- or hypervolemia Infection
Treatment Diuretics in those with fluid retention Furosemide more effective than thiazides ACE inhibitor or ARB in all patients Add after diuretic Make sure patient is not dehydrated before starting
Treatment Beta-blockers in all stable (minimal fluid retention) patients Others Spironolactone Nitrates and hydralazine If unable to tolerate ACE inhibitor Calcium channel blockers May be useful in diastolic failure but may worsen systolic failure
Created by: DianaB
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