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Heart Failure RCM:5 > Cardiac failure > Flashcards

Cardiac failure Flashcards

1
Q

What is heart failure

A

Failure of the heart as a pump to meet the circulatory needs

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2
Q

After a myocardial infarction, what types would the heart failure be

A

Chronic or acute

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3
Q

What is heart disease precipitated by

A

Pregnancy
ANaemia
Hyper and hypothyroidism
Fluid retaining drugs like glucocorticoids and NSAIDs

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4
Q

How does hyperthyroidism lead to heart disease

A

Can over stimulate the heart which would lead to heart failure

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5
Q

How does hypothyroidism

A

Can under stimulate the heart which would lead to heart failure

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6
Q

What does ischaemic heart disease affect

A

Impaired muscle function ie preload, after load, and muscle contractility

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7
Q

What is ischeamic heart disease

A

Coronary heart disease

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8
Q

How is hypertension a risk for chronic heart failure

A
  • For the increase in after load, you get left ventricular hypertrophy
  • This means the heart is less efficient at generating force
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9
Q

To compensate for circulatory failure, what gets activated in the body

A
  • Sympathetic nervous system
  • Renin-angiotensin-aldosterone system
  • ADH
  • Atrial Natriuretic Peptide (ANP)
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10
Q

How does the sympathetic nervous system compensate for circulatory failure

A

Acts on beta adrenoceptors which keeps the heart going

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11
Q

How does ADH compensate for circulatory failure

A

Conserves fluid which would lead to fluid overload

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12
Q

How does ANP compensate for circulatory failure

A

Released by failing atria which would lead to the excretion of sodium

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13
Q

What do the macula densa detect

A

Low sodium and low blood pressure and volume

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14
Q

What do the macula densa release

A

Renin

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15
Q

How does the renin-angiotensin system make heart failure worse

A
  • Renin chops up angiotensinogen to make angiotensin 1. This is chopped up to angiotensin 2 by angiotensin converting converting enzyme
  • From angiotensin 2, this leads to vasoconstriction and augments the sympathetic nervous system
  • It also acts on adrenal glands to release aldosterone which retains sodium and causes potassium loss

=ALl of these leads to increased effort needed by heart which is bad because there is higher pressure and more fluid

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16
Q

What does increased vasoconstriction lead to

A

Increased resistance which leads to impaired renal function and so further renin angiotensin cycle

17
Q

When does left-sided hypertension usually occur

A

Often after hypertension

18
Q

What does poor output from the left hand side lead to

A

Increase in left atrial and pulmonary venous pressure with pulmonary oedema

19
Q

What does right sided failure often lead to

A

Lung disease

Pulmonary valvular stenosis

20
Q

How is biventricular failure caused

A

Left ventricular failure leads to pulmonary congestion which may lead to right ventricular pressure

-Or ischaemic heart disease

21
Q

Symptom of pulmonary oedema

A

Shortness of breath (drowning sensation)

22
Q

What causes paxosymal nocturnal dysponoea

A

When a patient is lying down, it promotes venous return and so in those with oedema, the blood rushes back to heart and lungs

23
Q

What is peripheral oedema associated with

A

Right hand side failure

24
Q

What is the value of ejection fraction which is consistent with heart failure

A

45%

25
Q

Symptoms of right ventricular failure

A
  • Raised venous pressure
  • Increased jugular vein pressure
  • Enlarged liver
  • Peripheral oedema
26
Q

How to primarily diagnose heart failure

A

Echocardiogram which sees if the ejection fraction is less than 45%

27
Q

How is the BNP used to diagnose heart failure

A

When ventricles go into failure, they release BNP. Therefore if they are elevated it indicates heart failure

28
Q

How does heart failure lead to atrial fibrillation

A

-LEft ventricle/valve failure leads to increased pressure in the left atria which leads to distension which leads to atrial fibrillation

29
Q

Goals of treatment for heart failure

A
  • Reduce cardiac workload
  • Increase cardiac output
  • Counteract maladaptation
  • Prolng quality of life because the prognosis of heart failure is poor
30
Q

What does pulmonary oedema look like in a chest x-ray

A

Fluffy

31
Q

What is an indication of heart failure In a chest X-ray

A

Enlargement of the heart

32
Q

Symptoms od left ventricular failure

A
  • Awakening at night with shortness of breath.
  • Shortness of breath during exercise or when lying flat.
  • Chronic coughing or wheezing.
  • Difficulty concentrating and Fatigue.
  • Fluid retention causing swelling, or oedema, in the ankles, legs and/or feet.
  • Lack of appetite and nausea.

Heart Failure RCM:5 (10 decks)

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