CMap HF

 

Left Sided Heart Failure SYSTOLIC FACTORS

DIASTOLIC FACTORS

CAD * HTN*   Metabolic disorders* Myocarditis* Alcohol** Coccaine** Dilated cardiomyopathy* Acidosis (Drug toxicity, Resp/Metab acidosis)** Blood volume excess/Polycythemia* Anemia* Thyrotoxicosis* COPD, pulmonary embolism*

CAD* HTN* Decrease myocardial contractility

Hypertrophy* Fibrosis of advanced

Digitalis

age* Pericarditis* Myocarditis* Decrease cardiac

Ventricular

output

remodeling* Aortic stenosis* Collagen disease* Cardiomyopathy*

Decrease emptying

Decrease perfusion of

of the left ventricle

tissues of the body

Dysrhythmias* Valvular defects*

Anxiety Increase volume and end-diastolic BRAIN: Dizziness, lightheadedness,

pressure in left

confusion, restlessness, anxiety, insomnia

ventricle

STOMACH: indigestion

SKIN: pale/ashen, cool and clammy

Increase pressure in left atrium Vascular: compensate

Backflow of fluid in the lungs

stretch sensed by

Increase BUN & CREA

compensate

CXR: accumula tion of fluid in the lungs

Decrease ventricular

KIDNEY:

baroreceptors

Beta

Transudation of fluid from

Release renin;

capillaries to interstitial

passed by the liver

blockers

spaces of alveoli 

Dyspnea, SOB, ACE

breathlessness 

SNS stimulation’ released

inhibitors

Dry, hacking, non-

of epinephrine and

productive cough



(frothy and blood-

Rapid filling of

tinged, in severe)

alveolar spaces

Pulmonary

norepinephrine

Converted to

angiotensin I

crackles 

Decrease O2 sat



Orthopnea



Paroxysmal nocturnal dyspnea



Fatigue

Increase HR and contractility

ARBs Calcium

Pulmonary edema Converted to angiotensin II: potent

channel blockers

 

 

hydralazine

Stimulates adrenal Impaired Gas

gland to release

Exchange

aldosterone

Vasoconstriction

Activity Intolerance

diuretics

ECG; CBC: BNP; TSH; cardiac stress testing and

Fluid retention and stimulation of antidiuretic hormone Oliguria Nocturia

Increase BP Tachycardia

Altered sleep pattern

Palpitations

Increase Fluid Volume Ineffective tissue perfusion

Compensation Fails

Other medications: Antihyperlipidemic Anticoagulant Antiarrythmias

LEGEND: Factors Modifiable Fx - ** Nonmodifiable Fx - * Pathophysiology Signs/Symptoms –  Nrsg. Dx –  Dxtests –  Medications -

HEART FAILURE