CHF Flashcards
What is forward failure?
the inability of the heart to pump blood forward at a sufficient rate to meet the metabolic demands of the body
-low ejection fraction
What is backward failure?
the ability to only do so if the cardiac filling pressures are abnormally high
-high ejection fraction
What is the equation for ejection fraction?
(EDV-ESV)/EDV *100
What type of heart failure has reducted ejection fraction?
systolic heart failure
What type of heart failure has preserved ejection fraction?
diastolic heart failure
Which is more compliant right or left ventricle, which can tolerate larger changes in filling without major changes in pressure, which is very susceptible to acute changes in pulmonary vascular resistance?
right
What are alterations in ventricular shape and size following acute MI?
Seconds: acute alterations in ventricular dimensions
Hours-weeks: infarct expansion
Weeks-Years: hypertrophy/ dilation of non infarcted segment
What is the difference between concentric and eccentric remodeling?
concentric-thick
eccentric-thin
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Post MI does regional wall have more stress during the entire cycle?
yes
What are some post -MI remodeling that occurs in regional regional hypertrophy/dilation of non infarcted segments?
- cardiac myocyte hypertrophy
- cardiac fibroblast hyperplasia
- perivascular and interstitial fibrosis
- vascular remodeling and angiogenesis(angiogenesis can’t keep up)
- cardiac myocyte apoptosis
What are risk factors for developing post MI ventricular remodeling?
- infact size
- ejection fraction day 4
- infact loaction
- stroke index day 4
- TIMI grad
Does remodeling precede conjective heart failure?
yes by months to years
-efforts directed at preventing or slowing the progression of ventricular remodeling will prevent or deyal the development of CHF
What are some drugs that prevent ventricular remodeling?
ACE inhibit
Beta blockers
aldosterone antagonist
What are some drugs that prolong survival?
ACE inhib
Hydralazine+ Nitrates
Beta Blockers
Aldosterone antagonist
