Zusammenfassung der Ressource
Congestive Heart Failure
- Pathophysiology
- Diastolic
- Stiff Left Ventricle
- Impaired ventricular filling
- Decreased stroke volume
- Systolic
- Most affected by HTN,
valvular dysfunction, CAD
- Ventricle fails to pump enough blood
- Baroreceptors activate SNS
- Vascular system constricts to
increase vital organ perfusion
- Increased preload to increase contractility, and increased HR
- Reduced blood flow to the kidneys
- RAA system activated
- Further vasoconstriction and Na++ and H2O retention
- Classes of HF
- Class I
- Cardiac Disease
- No limitation in physical activity
- Class II
- Cardiac Disease
- Slight limitation in physical activity
- Comfortable at rest
- Symptoms with ordinary physical activity
- Class III
- Cardiac Disease
- Marked limitation in physical activity
- Less than ordinary activity results in symptoms
- Class IV
- Cardiac Disease
- Inability to carry on any physical activity without discomfort
- Symptoms even at rest
- Discomfort increased with any physical activity
- Lifestyle Factors
- Edema
- Daily weights
- Support stockings
- Nocturia
- Anasarca
- Hepatomegaly
- Coagulopathy
- Respiratory Distress
- May require supplemental O2
- Exertional Dyspnea
- Orthopnea
- Physical Limitations
- Decreased social interaction
- Decreased quality of life
- Reliance on others for ADL assistance
- Pharmacologic Management
- Loop Diuretics
- Reduces fluid retention
- ACE-I or ARB
- Prevent the conversion of A1 to A2
- A2 responsible for vasoconsrticion
- Decreased fluid retention
- Beta Blockers
- Decreased HR
- Increased diastolic filling time
- Decreased oxygen consumption
- Lower BP
- Digoxin
- Decreased HR
- Non-Pharm Management
- Salt Restriction
- Cardiac Rehab
- Support for chronic disease management