Cardiac: Conjestive Heart Failure

Question 1

what are 2 categories for congestive heart failure?

Answer 1

left- and right-sided failure

Question 2

name 5 things that cause left-sided heart failure?

Answer 2

1. ischemia
2. hypertension
3. dilated cardiomyopathy
4. myocardial infarction
5. restrictive cardiomyopathy

Question 3

dilated cardiomyopathy

Answer 3

heart muscles stretched too much and heart cannot contract

Question 4

restrictive cardiomyopathy

Answer 4

walls are rigid, and heart is restricted from stretching and filling with blood properly

Question 5

clinical features of left-sided heart failure are due to what 2 things

Answer 5

1. decreased forward perfusion

2. pulmonary congestion

Question 6

left sided heart failure pulmonary congestion leads to what

Answer 6

pulmonary edema

Question 7

pulmonary edema from left-sided heart failure results in what

Answer 7

• dyspnea
• paroxysmal nocturnal dyspnea ( increased venous return when lying flat)
• orthopnea
• crackles

Question 8

dyspnea

Answer 8

difficult or labored breathing

Question 9

orthopnea

Answer 9

is shortness of breath (dyspnea) which occurs when lying flat, causing the person to have to sleep propped up in bed or sitting in a chair

Question 10

pulmonary edema from left-sided heart failure can cause what

Answer 10

1. small, congested capillaries burst

2. leading to intraalveolar hemorrhage

Question 11

what does intraaveolar hemrrhage look like under the microscope

Answer 11

hemosiderin-laden macrophages

“heart failure cells”

Question 12

in left-sided heart failure decreased forward perfusion impacts what organ and causes what?

Answer 12

kidney

• activation of renin-angiotensin system
• exacerbates CHF

Question 13

what is the mainstay treatment for left-sided heart failure

Answer 13

ACE inhibitor

Question 14

what is the most common cause of right-sided heart failure

Answer 14

due to left-sided heart failure

Question 15

what are other causes of right-sided heart failure

Answer 15

1. left-to-right shunt

2. chronic lung disease (cor pulmonale)

Question 16

what are 3 clinical features of right-sided heart failure

Answer 16

1. jugular venous distension
2. painful hepatosplenomegaly
3. dependent pitting edema

Question 17

Hepatosplenomegaly

Answer 17

simultaneous enlargement of both the liver (hepatomegaly) and the spleen (splenomegaly).

Question 18

painful hepatosplenomegaly has what physical characteristic and can lead to what

Answer 18

• ‘nutmeg’ liver

- cardiac cirrhosis

Question 19

why does dependent pitting edema occur in right-sided heart failure

Answer 19

increased hydrostatic pressure

Question 20

cor pulmonale

Answer 20

isolated right heart failure due to pulmonary causes

Question 21

what side CHF is more common

Answer 21

left and systolic