Cardiac Failure Flashcards
what are some causes of CHF?
-MI
-inadequate valves
»_space; regurgitation
-external pressure
ex) pericardial effusion, cancer of the heart
how does vitamin B deficiency cause heart failure?
the heart cannot pump efficiently
ex) alcoholic patients
what is the general definition of cardiac failure?
Reduction in pumping ability of heart
● Due to deterioration of heart or worsening of factors external to heart (or both)
diastolic heart failure is a ____ issue
filling
systolic heart failure is a _____ issue
pressure
what is the result of systolic heart failure on cardiac function?
weakened muscle & decreased contractility
● leads to decreased ejection fraction (EF)
what can cause systolic heart failure?
● Damage to heart by infarction or ischemia
● Chronic overload (e.g. untreated HTN)
in systolic failure, stroke volume (SV) is_______, end systolic volume (ESV) is _______
- decreased
- increased
what happens to the size of the heart over time in systolic failure?
heart size increases due to increased filling
what is the most common cause of diastolic heart failure?
hypertension
how does hypertension cause diastolic dysfunction?`
● Heart wall thickens to relieve stress of chronically working against elevated aortic pressure
in diastolic failure, there is ______ afterload which results in impaired _____ of the ventricle walls -> intraventricular volume
decreases
- increased
- relaxation
diastolic heart failure is also called ______ cardiomyopathy
hypertrophic
Since volume capacity of L ventricle decreased, _____ _____ of blood is pumped out to the aorta
smaller amount
in diastolic failure, there is _____ contractility but the ventricle loses ______, resulting in an inability to expand
normal
-compliance
EF is _____ in diastolic heart failure
preserved
____ is the most common cause of right ventricular failure
left heart failure
what are pulmonary causes of right ventricular failure?
> HTN, COPD, severe pneumonia, PE
● Due to chronic causes – cor pulmonale
in right ventricular failure, there is _____ RV end-diastolic, atrial, and systemic venous pressures
increased
how does thyrotoxicosis cause right ventricular failure?
stimulation of heart to work harder
> high output cause
RV failure results in _____ in cardiac output and an accumulation of blood in ____ ventricle, _____ atrium, and _____ circulation
-decrease CO > RV > RA > systemic (back up of blood)
what are systemic symptoms seen in right ventricular failure?
- edema
- hepatosplenomegaly
- JVD
right sided heart failure results in an inefficient way for blood to get to the _____
lungs
what are some causes of left ventricular failure?
● MI, ischemia most common
● HTN
● Valvular
● Idiopathic dilated cardiomyopathy
left ventricular failure results in ____ in left ventricular end-diastolic, atrial, and pulmonary pressures and ____ cardiac output
increased
-decreased
where does blood accumulate when there is left ventricular failure?
- left ventricle
- left atrium
- pulmonary circulation
in right sided heart failure, what are some examples of GI tract congestion?
- anorexia
- GI distress
- weight loss
in right sided heart failure, there is congestion of ___ tissues which can lead to _____ edema nad ascites
- peripheral
- dependent
decreased cardiac output in left heart failure can results in:
activity intolerance & signs of decreased tissue perfusion
cyanosis and signs of hypoxia in left sided heart failure is due to _____ ___ ______ from pulmonary congestion
impaired gas exchange
what are symptoms that pulmonary edema can cause in left sided heart failure?
orthopnea
paroxysmal nocturnal dyspnea
cough with frothy sputum
what are some causes of high output heart failure?
● AV fistulas ● Beriberi heart disease ● Paget’s Disease ● Hyperthyroidism ● Pregnancy ● Anemia ● Sepsis
what are the physiologic processes that result in high output cardiac failure?
> excessive venous return
> heart cannot meet metabolic needs
what are causes of low output heart failure?
● CAD
● cardiomyopathy
what are the physiologic processes that result in low output cardiac failure?
disorders that reduce/decrease pumping ability of the heart
an endothelin compensatory mechanism for heart failure is by amino acid peptide stimulation by ____ & ___ (receptor/hormone) which increases mechanical stress, resulting in an increase of ___ release from the SR
ACE & antidiuretic hormone (ADH)
-calcium
inflammatory mediators such as ___ and ___ enhance neurohormonal activity when the heart tries to compensate in heart failure
TNF & interleuken
structural changes in heart failure are compensatory responses which include:
● Myocardial Hypertrophy & Remodeling
