Question

4. Describe the pathophysiology of cardiac decompensation and explain the clinical manifestations. warenen un w in pilanny edene .. a onthupree. 5. What does "BNP" stand for? What is the significance of the "BNP" in a cardiac patient? 6. Why are anticoagulants ordered for patients with decreased ejection fraction and atrial fibrillation? BE SPECIFIC 7. What is the association between Potassium level and digoxin toxicity? 8. Why is it important to check Potassium level before furosemide administration?

Answer 1

4. Sign and symptoms of cardiac decompensation are

Heart decompensation H Neusphormonal activational et aldosterone, Remin definite • ^ Catecholamines • 1 adenosine Nvasopressin I I ceghiac output y venous X congestion & intrerasulat increased Intraabdominal pressure Renal Cyptere vosotonatrictlon ton ti I decreased ll perfuse Renol 4 Hopauled Kidney Strande borgere i dpdgroup Careem dus allea it, water refonaton)

• increased faigue
• shortness of breath
• Swelling of ankles , leg and feet
• r as pid irregular heartbeat
• persistent cough

5 BNP stands for B type natriuretic peptide . It is secreted by cardiac cells in response to stretching which occurs by increased ventricular volume. Significance in cardiac patient : its level increases in heart failure and comes down when heart failure stables.

6. Anticoagulant are those drugs which prevent blood to clot. These drugs are prescribed in patient with decreased ejection fraction because there is hypercaoguable state in which there is increased risk of ischemic stroke, left ventricle thrombi and othere thromboembolic events.

in atrial fibrillation, there is blood stasis that can cause thrombi in atri. So as to prevent, anticoagulant like warfarin and aspir are prescribed

7. A low level of potassium causes digoxin toxicity.

8. Potassium level before furosemide
furosemide is a loop diuretic that in addition to diuresis causes hypokalemia. Hypokalemia furthur precipitates metabolic alkalosis. Therefore potassium levels should be checked.