The nurse is explaining risk factors of heart failure to a client. Which of the following risk factors are considered extrinsic factors?

Coronary artery disease
Diet and weight
Hypertension
Pregnancy

Explanation

• Extrinsic factors are external to the heart that place excessive demands upon the heart, and can contribute to heart failure. They include: coronary artery disease and hypertension, diets high in fat and sugar, and pregnancy)

• The most common cause of heart failure is coronary artery disease. CAD reduces blood flow through the coronary arteries and therefore reduces oxygen delivery to the myocardium

• High blood pressure forces the heart to work harder to eject blood. The heart eventually fails after prolonged high pressures

• Pregnancy increases the body demands for oxygen and is an extrinsic factor affecting heart failure. The workload on the heart increases in an effort to move blood

• Diets with a high glycemic index (GI) or glycemic load (GL) may contribute to the risk of CHD, along with a high intake of red meat and high-fat dairy products, and obesity

• Congenital defects (left-to-right shunts) increase preload, the initial stretching of the cardiac muscle fiber length before contraction. This is one of the intrinsic factors (arising from intrinsic disease or pathology) that can lead to heart failure

• Dysrhythmias are one of the intrinsic causes of heart failure, because it arises from within the heart. Other intrinsic factors are valve disease and cardiomyopathy

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