Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 1: Cardiovascular System > 19. Pathophysiology of Heart Failure > Flashcards

19. Pathophysiology of Heart Failure Flashcards

1
Q

Define Heart Failure

A

Syndrome that arises when the heart is unable to maintain an appropriate blood pressure without support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Definition of heart failure in Man

A

A clinical syndrome caused by an abnormality of the heart and recognised by a characteristic pattern of haemodynamic, renal, neural and hormonal responses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When heart failure occurs what other organ failure also occurs?

A

Kidney failure because they won’t be perfused enough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How much cardiac output do kidneys receive?

A

Kidneys receive 35-40% of cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List the causes of heart failure

A 
Arrhythmias
Valve Disease
Pericardial Disease
Congenital Heart Disease
Myocardial Disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are Arrhythmias?

A

Irregular heart beat - mainly tachycardias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are valve diseases?

A

mitral or aortic regurgitation or valve stenoses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are pericardial diseases?

A

If the pericardium becomes inflamed and fibrotic then the heart can’t relax and pump as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is congenital heart disease?

A

If there are holes or misconnections then there is an increased risk of heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the commonest cause of myocardial disease?

A

coronary heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Types of cardiomyopathy?

A
  • Dilated Cardiomyopathy (DCM) - specific or idiopathic
  • Hypertrophic Cardiomyopathy (HCM or HOCM or ASH)
  • Restrictive Cardiomyopathy
  • Arrhythmic Right Ventricular Cardiomyopathy (ARVC)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List some examples of myocardial disease?

A

Cardiomyopathy
HOCM = Hypertrophic obstructive cardiomyopathy
ASH = Asymmetrical Septal Hypertrophy
Hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What drugs can cause heart failure?

A

Overdosing on beta blockers - it can decrease heart rate so much you get heart failure
Anti-arrhythmics - cause dysfunction of the heart
Calcium antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is myocardial remodelling

A

When there is part of a heart that is thin and fibrotic so that when the heart contracts the fibrous tissue just expands - infarct expansion. In order to maintain normal pump activity the heart remodels itself.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does part of the heart tissue become thing and fibrotic?

A

When an infarction has happened in that area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define cardiomyopathy

A

Heart disease in the absence of a known cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the most common cause of young athletes dropping dead?

A

Hypertrophic cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Define dilated cardiomyopathy

A

The heart’s ability to pump blood is decreased because the left ventricle, is enlarged and weakened.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

List an infectious cause of dilated cardiomyopathy?

A

Viruses such as HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the toxins and poisonous causes of dilated cardiomyopathy?

A

Ethanol and cocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What drugs can cause dilated cardiomyopathy?

A

Chemotherapeutic agents and antiviral agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Define restrictive cardiomyopathy

A

The heart is restricted so can’t dilate normally. The ejection fraction is preserved by there is diastolic dysfunction so it’s slow in relaxing

23
Q

What is restrictive cardiomyopathy associated with?

A

Fibrosis, hypertrophy and scleroderma

24
Q

What is a common symptom of restrictive cardiomyopathy?

A

The patients will often be short of breath

25
Q

What infiltrative disorders are associated with restrictive cardiomyopathy?

A

Amyloidosis and sarcoidosis

26
Q

Define infiltrative disorders

A

Where there is infiltration of amyloid proteins and granulocytes into the heart muscle which impairs heart function

27
Q

What are the hormonal mediators in heart failure

A

Constrictors, dilators and growth factor

28
Q

During heart failure what hormone is increased?

A

Because the body things it is bleeding to death there is an increase in adrenaline, nor adrenaline and the sympathetic drive is switched on

29
Q

During heart failure what organ tries to increase blood pressure?

A

The kidney as it tries to retain salt and water so the RAS system is switched.

30
Q

What vasoconstrictors are produced in response to heart failure?

A

Endothelin-1, vassopressin and neuropeptide Y in the endothelial cells

31
Q

What peptide is checked when diagnosing heart failure?

A

Atrial natriuretic peptide (ANP)
High = impaired heart
Troponin I and T levels are also increase in heart failure

32
Q

What are the inflammatory markers and cytokines in heart failure specific to the heart?

A

Troponin T and Troponin I

33
Q

What are the inflammatory markers and cytokines in heart failure specific to the vessel wall?

A

ICAM-1
VCAM-1
E-selectin
P-selectin

34
Q

With heart failure what is the 5 year mortality rate?

A

50%

35
Q

What is the median survival time following diagnosis of heart failure?

A 
Men = 1.7 years
Women = 3.2 years
36
Q

What is most common symptom of heart failure

A

Fatigue - tiredness

37
Q

What is orthopnoea?

A

Breathlessness when lying down. Where is a slight decrease in pressure in the atria when patients are propped up making it easier for the heart to function

38
Q

What is PND?

A

Paroxysmal Nocturnal Dysopnoea - they start sleeping propped up and then slip down, they wake up gasping for air so they have to get up and go to the window for air - this is a sign of severe heart failure

39
Q

How does heart failure affect heart rate and pulses?

A

Patients may have an increased heart rate to maintain cardiac output and have weak pulses

40
Q

How does heart failure affect venous pressure?

A

Patients have increased venous pressure due to the elevated pressures in the right side of the heart

41
Q

How does salt and water retention caused by heart failure affect the body?

A

Peripheral oedema

42
Q

How does heart failure affect the liver and abdomen?

A

Hepatomegaly and ascites

43
Q

What can be seen on heart failure chest X-ray?

A

Increase in the cardio-thoracic ratio.

44
Q

What should the cardio-thoracic ratio be on a normal chest X-ray?

A

In normal people the width of the heart should not be more than 50% of the width of the thorax

45
Q

What is the reason for using the New York Heart association classification of functional capcity?

A

So you can tell whether a patient has improved after treatment

46
Q

List the classes and describe them?

A 
1 = virtually no symptoms - the heart is dysfunctioning but most things are fine
2 = slight limitation of physical activity
3 = marked limitation of physical activity
4 = the patient can’t get out of a chair or is in bed
47
Q

Describe the progression of heart failure?

A

There is a plateau and then it suddenly drops off. The last downwards section can happen in a matter of weeks or months

48
Q

What are the syndromes of heart failure?

A

Acute Heart Failure - Associated with pulmonary oedema
Circulatory Shock - Associated with cardiogenic shock (poor peripheral perfusion, oliguria, hypotension)
Chronic Heart Failure - Untreated, congestive, undulatinf, treated, compensated

49
Q

How will the patient look if there is a blockage of the coronary artery and the heart muscle dies?

A

They will look very sick, tachycardic, sweating, sitting upright in bed, very breathless, coughing up frothy sputum

50
Q

How do you treat pulmonary oedema?

A

Give diuretics to get rid of the fluid in the lungs

51
Q

What are the key investigations during heart failure?

A

ECG
Coronary Angiography - can show where there is a stricture
2D echocardiogram - you can see have the heart is actually pumping
MRI scanning

52
Q

What is the management algorithm for heart failure?

A
  1. Establish that patient has heart failure
  2. Determine aetiology of heart failure
  3. Identify concomitant disease relevant to heart failure
  4. Assess severity of symptoms
  5. Predict prognosis
  6. Anticipate complications
  7. Choose appropriate treatment
  8. Monitor progress and tailor treatment
53
Q

List the common drugs used for heart failure

A

Diuretics
Ace Inhibitors
Beta Blockers
Aldosterone Antagonists (Spironolactone)
Digoxin (for atrial fibrillation)
Devices (cardiac resynchronisatioin, implanted cardioverter defibrillator)

Year 1: Cardiovascular System (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions