Compensated Heart Failure

Question 1

What does compensation lead to?

Answer 1

Leads to decompensation leading to failure

Question 2

What are the six mechanisms of compensation?

Answer 2

Ventricle dilation
Sympathetic nervous stimulation
RAAS
Naturietic peptides (ANP and BNP)
Endothelins
Cardiac hypertrophy and remodelling

Question 3

True or false: compensated heart failure is clinically a symptomatic.

Answer 3

True

Question 4

What is the mechanism of compensation: Ventricle dilation for compensated heart failure?

Answer 4

Increases end diastolic volume, which then increases muscle strength and preload which increases cardiac output

Question 5

What are long term negative effects of the compensatory mechanism ventricle dilation?

Answer 5

Over stretch the heart and increase the oxygen requirement of the heart

Question 6

What is the SNS mechanism of compensation for compensated heart failure?

Answer 6

It’s aim is to increase the cardiac output via vasoconstriction, tachycardia, and increased contractility

Question 7

What does the RAAS system result in as a compensation mechanism of heart failure?

Answer 7

Increases preload

Question 8

What do naturetic peptides (ANP and BNP) do as a compensatory mechanism of HF?

Answer 8

Proteins that are secreted by the heart result in diureses and naturiuresis decreasing blood volume and preload

Question 9

What do endothelins do as a mechanism of compensation for HF?

Answer 9

They result in vasoconstriction and result in proliferation of smooth muscle cells and hypertrophy of the heart

Question 10

What does cardiac hypertrophy and remodelling do as a mechanism of compensation in HF?

Answer 10

An increased workload on the heart results in hypertrophy. Eventually a reduction in contractility occurs and as the heart requires more oxygen myocardial dysfunction occurs

Question 11

What are manifestations of heart failure?

Answer 11

Effects of impaired pumping
Presentation of HF (decreased CO)
Compensatory mechanisms
SNS

Question 12

How is HF diagnosed?

Answer 12

Risk factors
History
Physical assessment
Echo and ECG

Question 13

What is the chronic treatment for HF?

Answer 13

Treat the symptoms, decrease risk and increase fx.

Question 14

If the EF is less than 40% how do we treat HF?

Answer 14

ACE inhibitors and beta blockers

Question 15

If EF is greater or equal to than 40%, how do we great HF?

Answer 15

Treat the treatment cause and ace inhibitor with or without beta blockers

Question 16

What medication is used if EF is less than 40% on activity?

Answer 16

ARB, and then increase dose or add diuretics if the symptoms appear at rest

Question 17

What is another possible tx for HF if the defect is repairable?

Answer 17

Surgery