cardiac failure

Question 1

acute left cardiac failure- causes

Answer 1

acute CAS, especially acute myocardial infarction
hypertensive crisis
Valve heart diseases (acute mitral or aortic valve regurgitation)
paroxysmal arrhythmias, arrhythmias with rapid ventricular rate
Acute myocarditis
Acute tamponade
Aortic dissection
High output syndromes: thyrotoxicosis crisis, septicemia, shunt syndromes
Exacerbation of the pre-existing cardiac failure

Question 2

CLINICAL FORMS (acute left cardiac failure):

Answer 2

Paroxysmal nocturnal dyspnea
Cardiac asthma
Acute pulmonary edema

Question 3

acute pulmonary edema

Answer 3

interstitial and alveoli transudate
severe dyspnoea, orthopnoea,
unproductive cough initially, then with watery, frothy and blood-tinged sputum;
cyanosis, anxiety
crepitations and ronchi over the whole pulmonary fields,
tachycardia, ventricular gallop
peripheral vasoconstriction: pallor, olyguria, altered mental status

Question 4

chronic left cardiac failure

Answer 4

Exertional dyspnea; inspiration
Cough (dry)

The severity of dyspnea decreases when RIGHT cardiac failure occurs !!!

Question 5

right heart failure

Answer 5

may occur as pure right-sided failure (uncommon), or in association with LHF (common).

Question 6

acute RCF

Answer 6

Acute RVF = ACP (acute cor pulmonale)

Question 7

ACP (acute cor pulmonale)

Answer 7

Massive pulmonary thromboembolism (PTE)
PTE plus DVT= venous thromboembolism VTE

Risk factors VTE:
Age
Genetic thrombophilia (f.V Leiden, prothrombin mutations)
Prolonged immobilzation (including for fracture)
Hormone replacement therapy, oral contraceptive
Partum, postpartum
Surgery
Cancer (chemotherapy)

Question 8

chronic RCF

Answer 8

Peripheral stasis
Oliguria
peripheral cyanosis
Cardic exam:

Question 9

Cardic exam:

Answer 9

Harzer sign,
Loud S2, possible SV arrhythmias
Murmur TR

Question 10

NYHA classification- severity:

Answer 10

Class I: patients with no limitation of activities; no symptoms from ordinary activities.
Class II: patients with slight, mild limitation of activity; they are comfortable with rest or with mild exertion.
Class III: patients with marked limitation of activity; they are comfortable only at rest.
Class IV: patients who should be at complete rest, confined to bed or chair