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Chapter 22 Cardiac Failure Acute Pulmonary Edema Increased Venous Return Insufficient Pumping Buildup of Blood in Lungs Increased Capillary Pressure Buildup of Fluid in Lungs Peripheral Vasodilation Diminished O2 Transport Treatment for Pulmonary Edema Tourniquets on arms and legs Bleeding the Patient Diuretic (e.g. furosemide) Pure O2 to breathe Cardiotonic drug (e.g. ouabain) to strengthen the heart Cardiac Reserve Maximum amount that the CO can increase. Generally 300-400%. Can be 500-600% in athletes. Can be zero for diseased heart. Exercise Test Put on a treadmill Look for Shortness of breath Muscle fatigue Increased heart rate. Graphical Analysis of Cardiac Output AV Fistula Normal Normal Venous Return Heart Defects Patent Ductus Arteriosis (PDA) Tetralogy of Fallot (Left to Right Shunt) Blue Baby 4 abnormalities Aorta (partially) originates from RV Stenosed Pulmonary artery Blood from the RV passes through a septal hole Right Ventricular Hypertrophy German Measels is a common cause of heart defects. Extracorporeal Circulation Methods: Bubbling O2 through blood Dripping blood over a large surface Passing blood over rotating discs Passing blood through thin membranes or porous tubes Problems: Hemolysis, Clotting, Bubbles, Emboli of antifoam agent, need for large quantities of blood, need for heparin (inteference with hemostasis). Cardiac Hypertrophy Caused by Congenital and Valve Diseases Generally occurs with all defects Part of heart affected depends on type of defect Extreme hypertrophy can cause heart failure Coronary vasculature does not increase Fibrosis often develops (especially subendocardial) Ischemia can cause anginal pain.