Cardio - Understanding HF

Question 1

What is the definition of heart failure (HF)?

Answer 1

CLINICAL SYNDROME wherein the heart pumps an inadequate volume of blood to meet O₂ demands of tissue and prevent fluid accumulation

Question 2

HF occurs in the face of _____ venous return (as distinguished from shock).

Answer 2

adequate/high

Question 3

What type of diagnosis is HF?

Answer 3

Common end result of many different cardiac diseases - it is NOT a primary diagnosis

Question 4

What factors determine CO?

Answer 4

HR x SV

Question 5

What factors determine SV?

Answer 5

Preload, afterload, inotropy

Question 6

What is preload?

Answer 6

Amount of blood coming back into heart during diastole

Question 7

What is afterload?

Answer 7

All forces that resist ejection from the heart in systole

Question 8

What are potential causes for L-HF due to too much afterload?

Answer 8

Systemic hypertension, congenital SAS

Question 9

What are potential causes for L-HF due to too much preload?

Answer 9

Valvular disease (mitral, aortic)

Congenital - PDA, VSD, ASD

Question 10

What are potential causes of L-HF due to not enough contractility?

Answer 10

DCM, myocarditis

Question 11

What are potential causes of L-HF due to not enough relaxation/filling?

Answer 11

HCM

Question 12

What are potential causes of R-HF due to too much afterload?

Answer 12

Pumonary hypertension, congenital PS

Question 13

What are potential causes of R-HF due to too much preload?

Answer 13

valvular disease (tricuspid), congenital tricuspid dysplasia

Question 14

What are potential causes of R-HF due to not enough contractility?

Answer 14

DCM, myocarditis

Question 15

What are potential causes of R-HF due to not enough relaxation/filling?

Answer 15

Pericardial disease (tamponade), neoplasia

Question 16

What are the clinical signs of forward (low output) HF?

Answer 16

Syncope, pallor, cyanosis, hypokinetic pulses, azotemia

(Heart is not pumping enough blood to meet demands)

Question 17

What are the clinical signs of backward (congestive) HF?

Answer 17

Pulmonary edema, pleural effusion, ascites/hepatomegaly, pericardial effusion, peripheral edema

(This is the most common manifestation of HF in animals)

Question 18

What role does the LV play in congestive HF?

Answer 18

Blood comes into LV from LA, which came from the lungs –>

Fluid accumulates in lungs –> pulmonary edema

Question 19

What role does the RV play in congestive heart failure?

Answer 19

Blood comes into RV from RA, which came from systemic circ (vena cavae) –>

Cavitary effusions –> pleural eff, ascites, pericardial eff, peripheral edema

Question 20

Where does the fluid go in DOGS with L-CHF?

Answer 20

Pulmonary edema

Question 21

Where does the fluid go in DOGS with R-CHF?

Answer 21

Ascites = major

Occ = pleural effusion, pericardial effusion, peripheral edema

Question 22

Where does the fluid go in CATS with L-CHF?

Answer 22

Pulmonary edema, pleural effusion, pericardial effusion

Question 23

Where does the fluid go in CATS with R-CHF?

Answer 23

Ascites = major

(Also pleural effusion and pericardial effusion)

Question 24

A cat with pulmonary edema only and no other issues is _____ likely to have L-CHF.

Answer 24

not

Question 25

Which of the body’s neurohormonal compensatory systems respond to HF?

Answer 25

RAAS, sympathetic system

Question 26

What activates RAAS?

Answer 26

Juxtaglomerular apparatus senses decrease in renal perfusion;

Also increased SNS tone

Question 27

What are the short-term effects of RAAS?

Answer 27

Na+/H₂O retention –> increased preload

Vasoconstriction –> increased preload and afterload

Question 28

What are the long-term effects of RAAS?

Answer 28

Myocardial remodeling and fibrosis, renal and arteriolar sclerosis, cytokine activation

Question 29

What activates the SNS?

Answer 29

Baroreceptors sense a decrease in BP

Question 30

What are the short-term effects of the SNS?

Answer 30

Increased HR, increased contractility, vasconstriction –> increased preload and afterload

Question 31

What are the long-term effects of the SNS?

Answer 31

Myocardial remodeling and fibrosis, cytokein activation

Question 32

What pathophysiologic parameters can we alter pharmacologically to treat HF?

Answer 32

Increase inotropy, decrease preload, decrease afterload, optimize HR, blunt RAAS, blunt SNS