Brainscape's Knowledge GenomeTM

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


See full index

CVS > CVS 19 - Pathophysiology of Heart Failure > Flashcards

CVS 19 - Pathophysiology of Heart Failure Flashcards

1
Q

Define Heart Failure

(PJ Harris definition)

A

Syndrome that arises when the heart is unable to maintain appropriate BP without support

(it is a reflex response)

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

Define Heart Failure in man

A

Clinical syndrome caused by abnormality of the heart and recognised by a characteristic pattern of haemodynamic, renal, neural and hormonal responses.

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

Which organ is a particularly big part of heart failure?

A

The kidneys, as they are not perfused enough. (they receive 35-40% of CO)

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

What are the 5 causes of heart failure?

Arrow Vs Prometheus Coolest Matchup

A
  1. Arrhythmias
  2. Valve disease
  3. Pericardial disease
  4. Congenital Heart Disease
  5. Myocardial Disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Within myocardial disease, which is the most common cause of it?

A

Coronary Heart Disease

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

What are the types of cardiomyopathy? (cardiomyopathies are part of myocardial disease)

(Deathstroke Has Remained Alive)

A
  1. Dilated Cardiomyopathy (DCM) - specific or idiopathic (IDCM)
  2. Hypertrophic Cardiomyopathy (HCM/HOCM/ASH)
  3. Restrictive cardiomyopathy
  4. Arrhythmic RV Cardiomyopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which drugs can cause Heart Failure?

A
  1. OD on beta-blockers decreases the heart rate extremely
  2. Anti-arrhythmics can cause heart dysfunction
  3. Ca antagonists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is myocardial remodelling?

A

When the rest of the heart tries to remodel to maintain normal pumping activity as the fibrous tissue does not contract.

Occurs over months/years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is cardiomyopathy?

A

Heart disease in the absence of a known cause

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

What is the most common cause of young athletes dropping dead?

A

Hypertrophic cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Give some causes of dilated cardiomyopathy

A

Infectious diseases, toxins and poisons (e.g. alcohol/cocaine), chemotherapeutic agents, collagen disorders, etc

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

What are the 4 general causes of restrictive cardiomyopathy?

A
  1. Associated with fibrosis
  2. Infiltrative disorders
  3. Storage disorders
  4. Endomyocardial disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Patients with restrictive cardiomyopathy have a normal ejection fraction. What is different?

A

They have diastolic dysfunction so these patients are very slow in relaxing

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

What are the causes of death in heart failure?

A
  1. Progression of Heart failure (increased myocardial wall stress, increases Na/H2O retention)
  2. Sudden death (Opportunistic arrhythmia - most common cause of death)
  3. Cardiac event (MI) (or others e.g. stroke, pulmonary vascular disease)
  4. Non-cardiovascular cause (e.g. pneumonia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

There are many hormonal mediators in heart failure. Which 3 constrictors are present?

A
  1. NA - increased sympathetic drive
  2. Renin/angiotensin 2
  3. Endothelin-1 (and more e.g. vasopressin, NPY)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which are the most effective drugs to use for heart failure?

A
  1. Beta blockers (block sympathetic drive)
  2. ACE inhibitors. - block RAS
  3. Aldosterone receptor antagonists
17
Q

What is ANP and why is it important?

A

Used as part of diagnostic criteria for heart failure.

Atrial Natriuretic Peptide.

18
Q

What other levels are increased in heart failure?

A

Troponin and T levels

19
Q

What are some inflammatory markers/cytokines of Heart failure?

A

Heart : troponin T

Vessel Wall : ICAM-1, VCAM-1, selectins

Macrophages: phospholipase A2s

Adipose tissue

All cells also express more : IL 1B, IL 6, TNF a, CRP, Fibrinogen, Serum Amyloid A

20
Q

What is median survival following diagnosis?

A
  1. 7 years (M)

3. 2 years (F)

21
Q

What are some signs and symptoms of Heart failure?

A
  1. Tiredness (most common)
  2. Orthopnoea (patients must sleep propped up as less pressure in atria so easer contraction)
  3. PND (Paroxysmal Nocturnal Dyspnoea) - sleep propped up, if they slip they wake up gasping for air
  4. Many look like cancer patients
  5. Increased HR to maintain CO
  6. Weak pulses
  7. Increased venous pressured (due to elevated RHS pressures)
  8. Peripheral oedema due to salt and water retention
  9. Crepitations of the bases
  10. Hepatomegaly and ascites
22
Q

What are some features of a cardiac failure chest X-ray?

A

Increase in cardio-thoracic ratio (normally it should not be over 50%)

23
Q

How does the NYHA classify functional capacity of the heart?

(Functional Classification 1-4)

A

Class 1 - no limitation in physical activity, no real symptoms

Class 2 - slight limitation in physical activity

Class 3 - Marked limitation in physical activity

Class 4 - bed bound patient

24
Q

Describe quality of life progression of heart failure?

A

Initial plateau then suddenly drops off

25
Q

What are the syndromes of heart failure?

A
  1. Acute Heart Failure - (pulmonary oedema)
  2. Circulatory shock (cardiogenic shock - poor peripheral perfusion, etc)
  3. Chronic Heart Failure (untreated/undulating/treated/compensated)
26
Q

How are pulmonary oedemas treated?

A

Diuretics given asap

27
Q

NEVER GIVE BETA BLOCKERS TO?

A

Someone with Acute Heart Failure

28
Q

What are common drugs used for heart failure?

aside from devices

A
  1. Diuretics
  2. ACE inhibitors
  3. Beta blockers
  4. Aldosterone Antagonists
  5. Digoxin (for atrial fibrillation)
29
Q

If there is severe heart failure, what are the possible treatments?

A
  1. IV drugs (nitrates, positive inotropes, diuretics)
  2. Fluid control
  3. Devices
  4. Surgery

CVS (16 decks)

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