26 Heart Failure Flashcards

1
Q

what is the role of the heart

A

to provide a continuous supply of oxygen to the body parts using blood

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2
Q

what is heart failure

A

clinical syndrome that affects the ability of the heart to provide sufficient blood to meet the body’s needs

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3
Q

what are the two main types of heart failure

A

acute or chronic

but also classified as systolic or diastolic

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4
Q

what can heart failure lead to

A

myocardial infarction

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5
Q

Describe the anatomy of the heart

A

the heart is split up into 4 compartments which can be catagorised as the atria and the ventricles. Further catagorising as the left and right atrium and ventricles.
Think of it as a 2x2 grid.

The vena cava (superior above inferior below) goes into the right atrium which then passes through the tricuspid valve into the right ventricle where it goes through the semi lunar valve to the pulmonary artery.

pulmonary vein then goes to the left artia which then goes through the bicuspid valve to the left ventricle then to the aorta.

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6
Q

describe the blood flow around the body

A

blood is pumped to the right atria via the vena cava once within it passes through the tricuspid valve into the right ventricle which then goes through the semi lunar valve as its pumped out to the pulmonary artery which takes blood to the lungs to exchange carbon dioxide for oxygen.

Pulmonary vein takes blood to the left ventricle which then passes through the bicuspid valve into the left ventricle which is then pumped through the semi lunar aortic valve into the aorta.

blood goes from the aorta to the artery to the arterioles to the capilaries to the venuoles to the veins to the inferior or superior vena cava back to the right atria.

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7
Q

what is systolic heart failure

A

heart fails to pump the blood out of the ventricles fully

due to the thin and weak cardiac muscles.

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8
Q

what is diastolic heart failure

A

heart doesnt fill the blood efficiently

due to larger cardiac muscles and thus reduced ventricle sizes

further classified as left and right side diastolic heart failure

failure of one part of heart leads to the dysfunction of other parts of the heart

usually the left side gets affected first and moves to the right.

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9
Q

What is the total amount of blood pumped out per minute

A

normally 5L per minute

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10
Q

what is stroke volume

A

amount of blood pumped out for every beat

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11
Q

how do we calc cardiac output

A

stroke volume x heart rate = cardiac output

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12
Q

how does compensation occur

A

increasing stroke volume or beating faster

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13
Q

how do we calculate ejection volume/ fraction =

A

% of blood ejected by each beat

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14
Q

describe systolic heart failure

A

systolic action contraction of cardiac muscle to eject blood which are weakened. so cant eject the blood properly anymore.

Mainly caused by cardiac muscle death, thinner muscles and enlarged ventricles

ejection fraction is reduced although the filling is unaffected.

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15
Q

what are the causes of systolic heart failure

A

coronary heart disease as reduced blood supply to cardiac myocytes

cadiomyopathy heart muscle diseases weakens the muscles

valve disease can lead to backward blood flow to the atria. Increasing heart beat to meet demands

stenosis narrowing of aortic and pulmonary valves leading to reduction of stroke volume getting reduced so heart beats faster

cardiac arrhythmias leading to irregular heartbeats

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16
Q

describe diastolic heart failure

A

diastolic action - filling blood in ventricles from atria, reduced ventricle size due to thickening of muscles therefore reduced blood volume in ventricles. Ejection fraction may be same due to the reduced ejected volume and filled volume.

17
Q

what is hypertrophy

A

reduces the ventricle sizes

18
Q

what is stiffening of muscles

A

due to lack of o2 and get hardened, affect the contraction

19
Q

what are the causes of diastolic heart failure

A

hypertension (chronic) due to other metabolic diseases leading to smaller blood vessels make the heart to work harder to pump the blood. Thus increase the muscle growth reduces the size of the ventricles.

aortic stenosis restricts blood flow and makes harder to pump increasing muscle growth

cardiac myopathy, hypertrophyincreased muscle growth therefore more O2 needed

Stiffening of muscles affects the contractions

endocarditis - infection in endocardium

age
disease
alcohol
medications

20
Q

describe the activation of sympathetic nervous system

A

induces sympathetic nervous system to enhance the cardiac activity

receptors mediated effects contraction and relaxation

prolonged activation leads to receptor desensitisation

21
Q

how do we increase the preload

A

release aldosterone which increase the filling volume and stroke volume

increased muscle activity

22
Q

cardiac hypertrophy

A

increase the muscle growth to increase ejection

23
Q

what is decompensation

A

increased activity requires more O2 and if body can supply more blood leads to cell death

24
Q

what are the symptoms of heart failure left sided

A
shortness of breath
swelling of feet and legs
chronic lack of energy
difficulty sleeping at night due to breathing problems
swollen or tender abdomen with loss of appetite
cough with frothy sputum 
increased urination at night
confusion and or impaired memory
25
what are forward failure symptoms
Tiredness & fatigue - heart is not supplying enough blood/O2 to the body parts Decreased urination – due to lack of blood supply & reduce fluid loss Irregular heart beats – to supply more blood
26
what are backward failure
Pulmonary oedema - fluid back up in lungs due (congestion) to reduced pumping Difficulty breathing & coughing – due to congestion or fluid build up in lungs Weight gain – due to fluid build up
27
what are symptoms of right sided forward failure
Tiredness & fatigue – reduced supply to the lungs and thus lack of oxygenated blood Irregular heart beats – to supply more blood
28
what are symptoms of right side backward failure
Oedema - fluid back up in the body (congestion) extremities (e.g. legs) and jugular vein in the neck Weight gain – due to fluid build up Increased urination – due to more back up of blood
29
how can we diagnose heart failure
X ray Echocardiogram Blood tests
30
what are the 4 classifications of heart failure
asymptomatic - no symptoms and no impact on normal activities Class 2 mild heart failure - mild symptoms + occasional oedema and somewhat limited ability to exercise Class 3 moderate to severe heart failure - comfortable only at rest, noticeable limitations in exercise capacity Class 4 severe heart failure - symptoms experienced at rest not able to exercise without discomfort
31
what are early stage treatments of heart failure
regular exercise balanced healthy diet anti hypertensive drugs
32
what are late stage treatments
anti hyper tensive drugs ventricular assist device - directly connected to the affected ventricle and to the output blood vessel via a pump cardiac resynchronisation therapy - pacemaker connected to affected atria / ventricles and make them beat at the same time with same rate pacemaker connected to affected atria/ventricles and make them beat at the same time with same rate pacemaker with defibrillator to delivers a shock and control the fibrillation
33
what surgeries exist for heart failure
coronary angioplasty CABG Heart transplantation