2 What is Heart FailureResults from any structural or functional abnormality that impairs the ability of the ventricle to eject blood (Systolic Heart Failure) or to fill with blood (Diastolic Heart Failure).
3 Classification of Heart Failure based on area of affection Systolic failure- decreased. ContractilityCaused by:Coronary Artery DiseaseHypertensionValvular Heart DiseaseDiastolic failure- decreased. FillingCoronary artery disease.
4 Key Concepts of HFCO = SV x HR-becomes insufficient to meet metabolic needs of bodyEF< 40% is an indicator of decreased SV
6 Factors effecting heart pump effectiveness Preload:Volume of blood in ventricles at end diastoleDepends on venous returnDepends on compliance.AfterloadForce needed to eject blood into circulationArterial B/P, pulmonary artery pressureValvular disease increases afterload
7 Mechanism of HFAll organs (liver, lungs, legs, etc.) return blood to heartWhen heart begins to fail/ weaken> unable to pump blood forward-fluid backs up >Inc. pressure within all organs.Organ responseLUNGS: congested > “stiffer” , inc effort to breathe; fluid starts to escape into alveoli; fluid interferes with O2 exchange, aggravates shortness of breath.Shortness of breath during exertion, may be early symptoms > progresses > later require extra pillows at night to breathe > experience "P.N.D." or paroxysmal nocturnal dyspnea .Pulmonary edemaLegs, ankles, feet- blood from feet and legs > back-up of fluid and pressure in these areas, heart unable to pump blood as promptly as received > inc. fluid within feet and legs causes fluid to "seep" out of blood vessels ; inc. weight
9 Systolic Heart Failure Systolic failure- most common causeHallmark finding: Dec. in *left ventricular ejection fraction (EF)Due toImpaired contractile function (e.g., MI)Increased afterload (e.g., hypertension)CardiomyopathyMechanical abnormalities (e.g., valve disease)
10 Diastolic Heart Failure Diastolic failureImpaired ability of ventricles to relax and fill during diastole --> dec. stroke volume and CODiagnosis based on presence of pulmonary congestion, pulmonary hypertension, ventricular hypertrophy