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Small Animal Flash cards > 5. Heart Failure ( Clinical Aspects, Therapy, Emergency,) > Flashcards

5. Heart Failure ( Clinical Aspects, Therapy, Emergency,) Flashcards

1
Q

Clinical aspects

A

Insufficiency
Incongruence between vascular vol and circulatory blood vol
Heart failure
Cardiac output not enough to deliver necessary amount of blood to tissue
Decr in CO leads to increase in blood vol within vascular sys and so results in vascular congestion and fluid accumulation in tissue space (oedema)

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2
Q

Cardiac output

A 
Cardiac output  HRxStroke vol.
Stroke vol. =
Preload 
After load 
Contractility 
Heart rate 
Distensibility 
Rthym
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3
Q

Compensation

A

Prioritize
Arterial blood pressure in brain,heart,kidney
Arterial blood pressure in other organs
Venous blood pressure kept low

Neurohormonal compensatory processes

Neural compensatory processes
Increased sympathetic tone

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4
Q

Renin angiotensin aldosterone system

A

Na and h2o retention
K excretion
Vasoconstriction
Increased sympathetic tone
Myocardial fibrosis,necrosis and hypertrophy
Cardiac remodeling - left ventricular hypertrophy

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5
Q

Progression of cardiac failure

A 
Myocardial damage leads to congestion 
RASS becomes permanently activated 
Incr Hr
Insufficient oxygen supply to cardiomyocytes 
Further compensation 
Endothelin release
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6
Q

Inflammation and the heart

A

Heart failure leads to release of inflammatory mediators
Paracrine molecules, TNF alpha , interleukins
Inflammatory mediators lead to myocardial fibrosis, necrosis, apoptosis

Cause free radicals

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7
Q

Cardiac remodeling

A

Causes
Autonomic nervous system, RASS, inflammatory mediators

Microscopic
Macroscopic

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8
Q

Left sided heart failure

A 
Pulmonary oedema, pleural fluid accumulation
Tachypnoea, dyspnoea,
Cold extremities, hypothermia 
Cough
Mild pre-renal azotemia
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9
Q

Right sided heart failure

A 
Pleural and pericardial fluid accumulation 
Congestion in abdominal organs 
Ascites 
Congested jugular vein 
Positive hepatojugular reflex
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10
Q

Heart failure cs

A 
Ls chf 
Rs chf 
Weakness 
Exercise intolerance 
Weight loss 
Tachycardia
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11
Q

Medical therapy

A

Treat cause
Relieve symptoms
Slow progression

Decr. Preload 
Decr. After load 
Incr. contractility
Treat arrhythmias 
Treat neurohormal overcompensation
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12
Q

Decr. Preload

A

Diuretics
Loop: Furosemide, torsemide
Thiazides
K sparing diuretics: amiloride

Vasodilators
Pimobendan

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13
Q

Decr. After load

A

Arterial dialators.
Amlodipine
Pimobendan

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14
Q

Incr. Contractility

A

Calcium sensitisors
Pimobendan

Digoxin
Pde inhibitors
Beta adrenergic stimulators

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15
Q

Treatment of neurohormonal overcompensation

A

Ace inhibitors
Enalapril, benazepril
Spironolactone

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16
Q

Emergency treatment of cardiologic diseases

A 
Decr. Preload 
Decr. Afterload 
Incr. myocardial Contractility 
Sedation 
Treat arrhythmia

Furosemide + Pimobendan

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