Congestive Heart Failure (CHF) Flashcards

1
Q

What is Congestive Heart Failure?

A

Pump failure divided into right- and left- failure

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2
Q

What are the causes of left sided heart failure?

A

-Ischemia, HTN (concentric left ventricular hypertrophy), dilated cardiomyopathy (muscle can’t contract as well), myocardial infarction and restrictive cardiomyopathy

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3
Q

What causes the clinical features of left sided heart failure?

A
  • Decreased forward perfusion

- Pulmonary congestion

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4
Q

What does pulmonary congestion cause?

A

Pulmonary edema

  • Results in dyspnea, paroxysmal nocturnal dyspnea (due to increased venous return when lying flat), othopnea, and crackles
  • Small, congested capillaries may burst, leading to idntraalveolar hemorrhage; marked by hemosiderin-laden macrophages (‘heart-failure’ cells)
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5
Q

What does decreased forward perfusion cause?

A

Decreased flow to the kidneys which leads to activation of renin-angiotensin system.
-Fluid retention exacerbates CHF

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6
Q

What is the main treatment for Left CHF?

A

ACE inhibitor!

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7
Q

What causes right sided heart failure?

A

Left sided heart failure most commonly

-Other important causes: left-to-right shunt and chronic lung disease (cor pulmonae)

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8
Q

What are the clinical features of right sided heart failure? What causes these?

A

Congestion causes them:

  • Jugular venous distention
  • Painful hepatosplenomegaly with characteristic ‘nutmeg’ liver; may lead to cardiac cirrhosis
  • Dependent pitting edema (due to increased hydrostatic pressure)
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