7 Flashcards

1
Q

What is the cardiac afterload

A

Ventricular contraction and blood ejection against arterial resistance

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2
Q

What is the cardiac preload

A

Ventricular relaxation and filling of the heart via main capacitance veins

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3
Q

What is heart failure

A

Cardiac output insufficient to meet circulatory needs of the body

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4
Q

What are typical symptoms of heart failure

A

Breathlessness, ankle swelling and fatigue

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5
Q

What is usually the cause of heart failure

A

Ischaemia to the myocardium

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6
Q

What are two major types of heart failure

A

Systolic failure - contractility or force of contraction reduced
Diastolic failure - stiffening and inadequate relaxation

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7
Q

What are two major causes of heart failure

A

Ischaemic heart disease

Hypertension

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8
Q

What is the formula for EF

A

SV/EDV

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9
Q

What is occurs to the EF during heart failure

A

SV decrease and EDV increases

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10
Q

What is a case where EF can be normal yet the ventricle in failure

A

Diastolic dysfunction caused by hypertrophy

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11
Q

What occurs in right ventricular heart failure (3)

A

1) Right ventricle does not pump forward
2) Pressure in systemic circulation increases
3) Congestion in veins and leads to peripheral oedema

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12
Q

What occurs in left ventricular heart failure (3)

A

1) Left ventricle does not pump forward
2) Pressure in pulmonary circulation increases
3) Congestion within pulmonary veins leading to pulmonary oedema

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13
Q

What are some consequences of heart failure (5)

A

1) Cardiac output reduced
2) Reduced EF
3) Fluid retention
4) Vasoconstriction
5) Cardiac hypertrophy and fibrosis

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14
Q

What compensatory mechanisms are activated

A

SNS
RAAS
“hormonal” - atrial natriuretic factor, endothelin

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15
Q

What drugs work indirectly to decrease workload of heart (6)

A
ACEI
ARB
Diuretics
Aldosterone antagonist
B blockers
Nitrates
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16
Q

What drugs work directly to stimulate the heart (2)

A

Inotropic agents

B1-agonists

17
Q

How do ACEI and ARB treat heart failure

A

Decreased vasoconstriction

Decrease oedema

18
Q

How do diuretics and aldosterone antagonists treat heart failure (2)

A

Decreased oedema
Decreased BP
(but increase raas)

19
Q

How do B blockers treat heart failure (3)

A

Decreased HR
Decreased cardiac workload
Decreased RAAS

20
Q

What is the first line treatment for heart failure

A

ACEI

21
Q

When are cardiac stimulants useful

A

Patients with atrial fibrillation

22
Q

What is the MOA of digoxin

A

Inhibits Na/K/ATPase
Decreases Na/Ca2+ exchange
Increases intracellular Ca2+

23
Q

What are side effects of digoxin and its low TI (4)

A

Nausea
Vomiting
Bradycardia
Arrhythmia

24
Q

What are three effects of digoxin (Lanoxin)

A

1) Positive inotropic on the heart
2) Reduce serum renin and aldosterone level
3) Increases parasympathetic tone on the heart

25
Q

What is LCZ696

A

Inhibitor of neprilysin, an endopeptidase which degrades natriuretic peptides