NURS 371 Lecture Notes - Lecture 18: Dobutamine, Cardioversion, Furosemide
Document Summary
Syndrome where the heart is unable to pump enough blood to meet the metabolic demands of the body. Associated with longstanding htn, cad, mi, copd, pe. Sx: weakness, fatigue, acute confusion, pulmonary congestion, oliguria, dyspnea, soa. Blood backs up into left atrium and then pulmonary veins and into lungs causing pulmonary congestion. Sx: jvd, ascites, hepatomegaly, peripheral edema, weight gain, nocturia. Blood backs up into right atrium and into peripheral circulation. Blood backs up and pressure increases in pulmonary venous system. Left ventricle cannot relax and fill properly bc stiff. Dx based on hf symptoms with normal ef. Poor filling, cannot empty correctly, high pulmonary pressure. Compensatory mechanisms: sympathetic nervous system, increased activity in response to decreased cardiac output and bp. Co improves due to increased hr & increased contractility: neurohormonal response, renin angiotensin aldosterone system- na and water is retained. This further aggravates the heart: endothelin- potent vasoconstrictor.
