Cardiovascular Health: Heart Failure and Pulmonary Embolism

Perfusion

Blood flow through targeted tissues.

Capillary Hydrostatic Pressure

Pressure pushing blood into interstitial spaces.

Peripheral Pulses

Assessment of pulse regularity and warmth.

Capillary Refill

Time taken for color to return, < 2 secs.

Pitting Edema

Indentation remains after pressure is applied.

Non-Pitting Edema

No indentation remains after pressure is applied.

Cardiac Output (CO)

Volume of blood pumped by heart per minute.

Stroke Volume (SV)

Amount of blood ejected with each heartbeat.

Ejection Fraction

Percentage of blood pumped out of ventricles.

Mean Arterial Pressure (MAP)

Average blood pressure in a person's arteries.

Creatinine Kinase (CK)

Enzyme indicating myocardial infarction severity.

Troponin I

Marker for cardiac muscle necrosis.

C-Reactive Protein (CRP)

Indicator of inflammation associated with CAD.

Electrocardiogram (ECG)

Test measuring electrical activity of the heart.

Antihypertensives

Medications to lower blood pressure.

Diuretics

Medications that increase urine output.

Cardiac Glycoside

Medication that increases cardiac output.

Anticoagulants

Medications preventing blood clot formation.

Thrombolytics

Drugs that dissolve blood clots.

Heart Failure

Inability of heart to meet metabolic demands.

Systolic Dysfunction

Impaired contraction of the heart.

Diastolic Dysfunction

Impaired filling of the heart.

Frank Starling Mechanism

Increased stretch leads to stronger contractions.

Neuroendocrine Response

Hormonal response to maintain blood flow.

Ventricular Hypertrophy

Thickening of heart muscle due to workload.

Dilation

Enlargement of heart chambers.

Left Sided Heart Failure

Most common cause of right sided heart failure.

Cardiac Stress Test

Evaluates heart function under stress.

Pacemaker Insertion

Surgical procedure to regulate heart rhythm.

Systolic heart failure

Type of heart failure with reduced EF

Diastolic heart failure

Type of heart failure with preserved EF

Left sided heart failure

Can lead to right sided heart failure

Right sided heart failure

Caused by conditions that restrict blood flow to the lungs

High output heart failure

A type of heart failure characterized by increased cardiac output

Acute heart failure

A sudden onset of heart failure symptoms

Chronic heart failure

A long-term condition where the heart does not pump blood as well as it should

Systolic function

Refers to the contraction phase of the heart

Diastolic function

Refers to the relaxing and filling phase of the heart

Left sided heart systolic failure

Impaired contraction of ventricles to eject sufficient volume of blood into the arteries

Myocardial infarction

A condition that can affect contractility of the heart

Dilated cardiomyopathy

A condition that can affect contractility of the heart

Preload

Increased with decreased contractility

Mitral valve regurgitation

A condition that increases preload

Aortic valve regurgitation

A condition that increases preload

Left sided diastolic heart failure

Characterized by decreased filling and high afterload

Ventricular hypertrophy

A condition that can lead to impaired relaxation of heart muscle

Hypertension

Can cause elevated afterload due to resistance of the outflow

Aortic valve stenosis

Can cause elevated afterload due to resistance of the outflow

Tricuspid valve regurgitation

Can lead to increased preload and decreased contractility

Pulmonary stenosis

A condition that can cause increased pressure in the pulmonary vasculature

COPD

A condition that can cause increased pressure in the pulmonary vasculature

Risk factors of heart failure

Includes CAD, hypertension, diabetes mellitus, congenital heart defects, smoking, obesity, and alcohol abuse

BNP

A test used to diagnose heart failure with values indicating severity

Serum electrolytes

Includes calcium and magnesium, important for diagnosing heart failure

Fluid volume management

Involves monitoring lung sounds, urinary output, and daily weight

Dietary consult

Recommended for patients with heart failure to manage sodium intake

ACEI / ARB

Medications that can cause hyperkalemia as a side effect

Heart transplant

Treatment of choice for end stage heart failure

Pulmonary embolism

Obstruction of blood flow in the pulmonary vascular system, a medical emergency

Virchow's triad

Consists of hypercoagulability, stasis, and endothelial damage

Popliteal veins

Veins located behind the knee that can be involved in thrombus formation.

Iliofemoral veins

Veins in the pelvis and thigh that can be involved in thrombus formation.

Thrombus

A blood clot that forms in a blood vessel and remains attached to its place of origin.

Embolism

A condition where a thrombus breaks loose and travels through the bloodstream to lodge in a vessel.

Pulmonary Embolism (PE)

A sudden blockage in the pulmonary arteries, usually caused by a blood clot from the deep veins in the leg.

D-dimer

A fragment of fibrin formed during the lysis of blood clots, used as a diagnostic marker for clotting.

CT with contrast

A diagnostic imaging technique used to locate pulmonary embolism.

V/Q lung scans

A test that involves injecting isotopes and scanning the lung field to assess ventilation and perfusion.

Chest x-ray

An imaging test used to identify pulmonary infiltrates and pleural effusion.

ECG

An electrocardiogram used to rule out myocardial infarction.

ABG

Arterial blood gas test that initially shows respiratory alkalosis with hypoxemia and metabolic acidosis due to hypoxemia.

End-tidal carbon dioxide (ETCO2)

A measurement that decreases with pulmonary embolism.

Embolectomy

Surgical removal of an embolus.

Heparin

An anticoagulant medication used in bolus and infusion for treating blood clots.

Warfarin

An anticoagulant that requires 5-7 days before discontinuing heparin.

INR

International normalized ratio, a measure of blood coagulation, with a target range of 2-3 for patients on warfarin.

Fibrinolytic therapy

Treatment using clot-busting medications to dissolve blood clots.

Vitamin K

An antidote for warfarin overdose.

Virchow's Triad

A model explaining the three factors that contribute to thrombus formation: stasis of blood flow, hypercoagulability, and endothelial damage.

Deep vein thrombosis (DVT)

Formation of a clot in the deep veins, often in the legs.

Homan's sign

A clinical sign indicating DVT, where dorsiflexion of the foot causes pain.

Doppler ultrasound

A diagnostic test used to visualize blood flow and detect clots.

Venography

An imaging test that uses contrast to visualize veins and detect clots.

Calf exercises

Exercises recommended for clot prevention, especially in patients at risk.

Thrombectomy

Surgical removal of a blood clot.

Fibrinolytics

Medications used to dissolve blood clots, with associated bleeding risks.

Pneumatic compression devices

Devices used to prevent DVT by promoting blood flow in the legs.

Supportive stockings

Compression garments used to enhance venous return and prevent clot formation.

Compression stockings

Elastic garments to prevent blood pooling.

Enoxaparin

SQ anticoagulant for clot prevention.

SCDs

Sequential compression devices for DVT prevention.

aPTT

Monitors heparin therapy, normal range multiplied by 1.5-2.5.

Protamine sulfate

Antidote for heparin overdose.

PT/INR

Monitors warfarin therapy; therapeutic INR is 2-3.

TPA

Thrombolytic agent for clot dissolution.

IVC filter

Prevents clots from entering heart/lungs.

Left Heart Failure

Weak pump due to myocardial damage.

Right Heart Failure

Often results from left heart failure.

Aldosterone

Hormone that retains sodium and water.

ACE inhibitors

Lower blood pressure without affecting heart rate.