[17] Heart Failure Flashcards
What is heart failure?
When the heart cannot deliver adequate cardiac output to meet the metabolic needs of the body
What might the symptoms of heart failure be manifested by?
Symptoms of poor perfusion, and/or symptoms of congestion of circulation
What follows compromise of cardiac stroke volume in heart failure?
Cardiac decompensation and heart failure
What are the underlying pathophysiological mechanisms that lead to compromise of cardiac stroke volume, cardiac decompensation, and heart failure?
- Increased afterload (pressure work)
- Increased preload (volume work)
- Myocardial abnormalities
- Tachycardias
What is heart failure usually due to in neonates?
Obstructed systemic circulation
What are the causes of obstructed systemic circulation in neonates?
- Hypoplastic left heart syndrome
- Critical aortic valve stenosis
- Severe coarction of the aorta
- Interruption of the aortic arch
What is heart failure usually due to in infants?
High pulmonary blood flow
What can cause high pulmonary blood flow in infants?
- Ventricular septal defects
- Atrioventricular septal defects
- Large persistent ductus arteriosus
What are the causes of heart failure in older children and adolescents?
- Eisenmenger syndrome
- Rheumatic heart disease
- Cardiomyopathy
What are the clinical features of heart failure?
- Breathlessness, particularly on feeding and exertion
- Sweating
- Poor feeding
- Recurrent chest infections
- Poor weight gain or faltering growth
- Tachypnoea
- Tachycardia
- Heart murmur/gallop rhythm
- Enlarged heart
- Hepatomegaly
- Cool peripheries
What investigations should be done in heart failure?
- CXR
- Echo
- ABG
- ECG
- Serum electrolytes
What may be found on CXR in heart failure?
Cardiac enlargement and oligaemic lungs with pleural effusions
What may be found on echo in heart failure?
Congenital heart defects
What may be found on ABG in heart failure?
Reduced pO2 or metabolic acidosis
Why should ECG be done in heart failure?
May help determine aetiology
