acute heart failure

Question 1

etiology

Answer 1

• Primary causes → IHD, MI, Myocarditis, Sclerosis
• aortic valve insufficiency & mitral valve insufficiency
• stenosis of the aorta, arterial HPT (1° & 2°)
• Q8.
• Pulmonary diseases- acute pneumonia, acute cor pulmonale, thromboembolism of pulmonary artery.
• Brain insult or trauma
• Toxicity

Question 2

types

Answer 2

• Right & left
• Systolic & diastolic
• Low output & high output
• Forwards & backward

Question 3

pathogenesis

Answer 3

• Small cardiac output due to ↓ contractility of the cardiac muscle
• Activation of sympathetic nervous system
  Spasm of a.a & v.v
  Tachycardia development
• Small bf in the kidney (ischemia)
• Activation of the renin angiotensin converting system → spasm of a.a & v.v
• Aldosteron system activation
  Improve reabsorption of Na+ & H2O
  a.a.r enlargement circulation blood. Blood stagnation
• Dilatation chambers of the heart
• ↓ contractility of the cardiac muscle. Decrease cardiac output
• Heart failure develop.

Question 4

clinical symptoms

Answer 4

1. left sided heart failure:
   a. interstitial edema
   - fatigue, dizziness, inspiratory dyspnea, orthopnea, dry cough at onset, foamy pinkish sputum
   - peripheral cyanosis, cold sweat, pale grayish skin.
   - weak cardiac activity, tachycardia, poor pulse,
   - auscultation - crepitation and moist rales in lower part of lungs, weak cardiac sound, gallop rhythm, and systolic murmur
   - percussion reveal dilated left ventricle.
   b. alveolar edema
   - more intensive dyspnea, cough with pink foamy sputum, tachypnea
   - central diffuse cyanosis, skin is pale grayish, cold skin
   - auscultation- diffuse intensive moist rales, bronchial breathing, gallop rhythm
   - percussion – dilated left ventricle
2. right sided heart failure
   - headache, nausea, vomiting, dyspnea, dizziness, fatigue, discomfort in chest
   - dilation of neck veins, epigastric pulsation.
   - hepatomegaly with positive plesh sign
   - ascities, hydrothorax, tachycardia, cough with bloody sputum
   - central cyanosis in face and chest
   - oliguria
   - encephalopathy, loss memory.
   - auscultation- gallop rhythm
   - percussion- dilated right ventricle.
   - edema of legs
   - fluid in pericardium
   - anasarca (edema appears in evening and disappears in morning)
   - urine: presence of protein, leucocyte and erythrocyte, increase density
   - gastritis, colitis, cachexia