Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PNS/Cardiology > Congestive Heart Failure > Flashcards

Congestive Heart Failure Flashcards

1
Q

What is the definition of heart failure?

A

Inability of heart to pump blood sufficiently to meet metabolic needs of body
OR
ability to do so, but with an abnormally high filling pressure (ventricular pressure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What happens to stroke volume when you increase preload?

A

Increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What happens to stroke volume when you increase contractility?

A

Increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What happens to stroke volume when you increase afterload?

A

Decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the two causes of an increase in ventricular end-diastolic pressure?

A

Increase in diastolic volume

Increase in diastolic stiffness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes an increase in end-systolic volume?

A

Increase in afterload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the formula for ejection fraction?

A

(EDV-ESV) / EDV = stoke volume / EDV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are symptoms of left-sided heart failure?

A 
Dyspnea on exertion (DOE)
Shortness of breath (SOB)
Orthopnea
Paroxysmal nocturnal dyspnea (PND)
Fatigue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are symptoms of right-sided heart failure?

A

Jugular venous distension
Peripheral edema
Hepatomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the major etiologies of heart failure?

A 
Coronary heart disease
Hypertension
Cardiomyopathy (dilated, hypertrophic, or infiltrative)
Valvular heart disease
Pericardial disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the common denominator of right sided heart failure?

A

Increase in right ventricular diastolic pressure –> increase in venous pressure –> peripheral edema and passive liver congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the common denominator of left sided heart failure?

A

Increase in left ventricular diastolic pressure –> increase in pulmonary capillary pressure –> transudation of fluid into lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are causes of stiffening of a ventricle (which then causes increase in ventricular end-diastolic pressure)?

A

Myocyte abnormality (ischemia or hypertrophy)
Fibrosis
Loss of elasticity
Age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a normal ejection fraction?

A

> 0.50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a poor ejection fraction?

A

<0.30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the two categories of heart failure based on systolic function?

A

HFREF (heart failure with reduced ejection fraction)

HRPEF (heart failure with preserved ejection fraction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why does abnormal systolic function in HREF lead to increased LV diastolic pressure?

A

Poor contraction –> heart dilates to maintain SV –> increases end diastolic pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why would patients with preserved systolic function in HRPEF have increased LV diastolic pressure?

A

Impaired relaxation or decreased compliance (stiff LV) –> increases end diastolic pressure but no effect on systolic function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are causes of HFREF?

A

Dilated cardiomyopathy
Myocardial infarction (not enough muscle)
“End stage” hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are causes of HFPEF?

A

Left ventricular hypertrophy (hypertension, aortic valve stenosis)
Hypertrophic cardiomyopathy
Restrictive cardiomyopathy
Constrictive pericarditis

21
Q

What lab tests can be used to determine if heart failure and the etiology?

A

Chest x-ray
Echocardiogram
Gated blood pool scan or MUGA (multiple gated acquisition scan)

22
Q

What are 3 different types of cardiomyopathy?

A

Dilated
Hypertrophic
Infiltrative

23
Q

What will you see on an echo for dilated cardiomyopahy?

A

Dilated ventricle, poorly contracting

24
Q

What will you see on an echo for hypertrophic cardiomyopathy?

A

Left ventricular hypertrophy, often asymmetric and vigorously contracting

25
Q

What will you see on an echo for infiltrative cardiopyopathy?

A

Looks like left ventricular hypertrophy, but is actually just infiltrated by amyloid

26
Q

What are secondary causes of dilated cardiomyopathies?

A

Alcohol
Beriberi
Coxsackie, Cocaine
Doxorubicin

27
Q

Do the following characteristics increase, decrease, or stay normal in dilated cardiomyopathy?

  • LV cavity size
  • Wall thickness
  • LV contractility
A

LV cavity size - increased
Wall thickness - normal
LV contractility - decreased

28
Q

Do the following characteristics increase, decrease, or stay normal in hypertrophic cardiomyopathy?

  • LV cavity size
  • Wall thickness
  • LV contractility
A

LV cavity size - decreased or normal
Wall thickness - increased
LV contractility - increased

29
Q

Do the following characteristics increase, decrease, or stay normal in infiltrative cardiomyopathy?

  • LV cavity size
  • Wall thickness
  • LV contractility
A

LV cavity size - normal
Wall thickness - increased
LV contractility - decreased or normal

30
Q

What is a gated blood pool scan or MUGA (multiple gated acquisition scan)?

A

Nuclear labling of read blood cells

Examine radioactivity of amount of blood in cavity at any one time

31
Q

What are the goals of therapy for heart failure?

A

Treat hemodynamic abnormalities (treat symptoms)

Treat neurohumoral abnormalities (improve long term survival and preventing remodeling)

32
Q

What are the categories of drugs used to treat heart failure?

A

Diuretics
Inotropes
Vasodilators (venous and arterial)
Neurohumoral antagonists

33
Q

What categories of drugs are used to treat hemodynamic abnormalities (symptoms) of heart failure?

A

Diuretics
Inotropes
Vasodilators

34
Q

What categories of drugs are used to treat neurohumoral abnormalities (improve long term survival) of heart failure?

A

ACE-I
ARB
Spironolactone
Beta-blockers

35
Q

What is the mechanism of action of diuretics?

A

Decrease sodium and water via kidney –> decreases intravascular volume –> decreases preload –> decreases pulmonary and peripheral congestion (edema) –> decreases symptoms of heart failure

36
Q

What are side effects of diuretics?

A 
Overdiuresis
Electrolyte disturbances (hypokalemia, hypomagnesemia)
37
Q

What is the mechanism of action of inotropic drugs?

A

Increase availability of intracellular calcium, increasing the force of ventricular contraction

38
Q

What are side effects of inotropic drugs?

A

Cardiac: arrhythmias, AV block
GI: nausea, vomiting
Other: yellow vision, gynecomastia

39
Q

What is the mechanism of action of venous vasodilators?

A

Increase venous capacitance –> blood pools in legs –> decreased venous return to heart –> decreased LV preload –> decreases pulmonary and peripheral congestion (edema) –> decreases symptoms of heart failure

40
Q

What is the mechanism of action of arteriolar vasodilators?

A

Reduces TPR –> reduces LV afterload

41
Q

What are side effects of venous vasodilators?

A

Headache
Hypotension
Tolerance

42
Q

What are side effects of arteriolar vasodilators?

A

Hypotension

Lupus-like syndrome

43
Q

Describe how neurohormonal response can worsen LV function?

A

Impaired LV function –> neurohumoral imbalance –> increased systemic vascular resistance –> increased afterload –> further impaired LV function

44
Q

Describe the cycle of ventricular remodeling and heart failure

A

Reduced cardiac function –> ventricular dilation –> elevated wall stress –> relative myocardial ischemia –> energy depletion –> progressive interstitial fibrosis –> further activation of adrenergic and RAAS –> reduced cardiac function

45
Q

If patient has low EF and signs and symptomas of fluid retention, what drugs should they be given?

A

Diuretic
ACE-I
Beta-blocker

46
Q

If patient has low EF and NO signs and symptoms of fluid retention, what drugs should they be given?

A

ACE-I

Beta blocker

47
Q

If patient has normal EF, what drugs should they be given?

A

Diuretics, but need to treat the underlying causes like hypertension and coronary disease

48
Q

What lab measurement can indicate heart failure?

A

BNP

Gets released from ventricle due to stretch of myocytes, so it increases with heart failure

PNS/Cardiology (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions