Cardiovascular Pathology Pt. 2 Flashcards
Heart Failure - Definition
Unable to pump enough blood to meet body’s demand. A weak heart or it cannot overcome increased blood pressure. Not a disease but a complex of symptoms.
Main types of failure:
Systolic heart failure: can’t pump with enough force (pump problem).
Diastolic heart failure: can’t fill with enough blood (filling problem).
Heart Failure - Classification
- Left or Right (according to the heart side)
- High or Low output (according to the blood volume pumped)
- Acute or Chronic
Heart Failure - Consequences
Critical reduction of the ejection fraction of the heart.
Beating harder or faster → OK in early stage → can become overworked → needing more O2 → cell death ↓stroke volume.
Heart Failure - Consequences
Critical reduction of the ejection fraction of the heart.
Beating harder or faster → OK in early stage → can become overworked → needing more O2 → cell death ↓stroke volume.
Left Sided Heart Failure - Description and Cause
Most common. Left ventricle not efficiently pumping blood out → Blood stays in lungs, congestion. Cause: - Arterial hypertension - Valve disease - Ischemic heart disease - Myocardial infarction - Arrhythmia
Left Heart Failure - Concequences
- Pulmonary edema
- Pleura effusion
- Dyspnea, tachypnoea, orthopnea
- Reduced exercise capacity
- Can lead to right heart failure => Global failure
Right Heart Failure - Description and Cause
Right ventricle not efficiently pumping blood to lungs → Blood can flow back to body, congestion (feet or abdomen).
Causes:
- Valve failure
- Left heart failure with pulmonary edema
- Pulmonary diseases with pulmonary arterial hypertension
Right Heart Failure - Consequences
- Leg edema
- Nocturia
- Liver edema
- Ascites (accumulation of fluid in abdominal cavity)
- Nausea/loss of appetite
Global Heart Failure - Description and Cause
Limited pump function of both ventricles.
Usually stems from left side failure. Left to right heart failure.
Heart Failure - Consequences and Diagnosis
Consequences: - Reduction of the physical capacity - Risk of cardiovascular fail - Reduced blood flow to visceral organs Diagnosis • Medical history • Echocardiogram • Blood tests
Heart Failure - Classification according to New York Heart Association
I. No dyspnea/symptoms
II. Mild dyspnea during ordinary activity
III. Marked limitation during ordinary activity
IV. Severe limitations, Dyspnea at rest
Heart Failure - Risk Factors
- Arterial hypertension
- Diabetes mellitus
- Smoking
- Abuse of alcohol
- Overweight
- Physical inactivity
Heart Failure - Treatment
• Underlying cause • Medication • Exercise • Education • Nutrition Heart Transplant - LAST RESORT
Disturbances in Cardiac Rhythm
Can originate from normal conduction pathway: SA node, AV node.
Can originate from outside pathway: where myocardium is irritable (depolarization of conduction pathway).
Can arise from atria or ventricle.
Pacemaker/Internal Defibrillator
Stimulate the heart with electrical impulses to maintain or restore a normal heart rhythm and enhance the cardiac function.
- Sinus node dysfunction
- Acquired Atrioventricular(AV) block
- After acute phase of myocardial infarction
- Hypertrophic cardiomyopathy
Cardiac Valve Disease - Stenosis vs Regurgitation
Restriction of valve opening (stenosis) or of valve closing (regurgitation)
• 1) obstruction of flow → ↑ pressure
• 2) inadequate valve closure → volume overloading
Aortic Valve Stenosis
Most common, narrowed opening.
↑ Pressure overloading left ventricle → left ventricle hypertrophy →difficulties pumping blood to rest of body.
Creates a afterload problem.
Aortic Valve Regugitation
Inadequate closing.
Backflow of blood into ventricle.
Volume overloading left ventricle → dilation of ventricle → heart failure.