Cardiac function

Question 1

Two types of Heart Failure?

Answer 1

Diastolic: Preserved EF/HFpEF, EF> 40-50%,. An issue with filling, heart can not adequately filled. Concentric remodelling

Systolic: reduced EF/HFrEF, EF<40-50%, can not pump out enough ,dilated heart, eccentric remodelling

Question 2

Factors that go with HFpEF

Answer 2

• HFpEF: HT, older, female, diabetic, AF, CKD
• Associated with exercise, not rest
• No effective treatment, can treat symptoms
• Diagnosis unclear: signs/sypmtoms of HF + normal systolic function? LV diastolic dysfunction

Question 3

Three parts of diastole and functions

Answer 3

• IVR: where X bridge detachment, calcium removal, elastic recoil of tissue
• Compliance: Early filling, associated with titin. If stiff titin, will not be as complaint during relaxation
• Collagen during filling, what influences is amount, cross linking

Question 4

What things influence diastole

Answer 4

• Lusitropy: tension relase when calcium detaches, titin recoil after compression. Afterload effects rate of relaxation
• Passive stretch: AV pressure gradient, chamber stiffness
• Atrial contraction: abnormal in AF

Question 5

How systolic and diastolic curves alter on pressure volume loops

Answer 5

Systolic: Left shift when inotrpy increases, left shift decrease in inotropy
Diastolic: less compliant, shifts up, more compliant, shifts down

Question 6

Causes of pulmonary hypertension

Answer 6

• Loss of capillary beds, bullous changes in COPD/PE
• VC caused by hypoxia, hypercapnia or both
• Increased alveolar pressure (COPD, mechanical vent)
• Medial hypertrophy in arterioles (HT)

Question 7

Atrial fibrillation time course

Answer 7

Paroxysmal: Brief periods which revert spontaneously. Drugs are used to control rhythm
Persistent: Stays for longer, can cardiovert with defibrillation
Permanent: Cardioversion ineffective, can not stop rate control