Developmental Flashcards
What are the 3 developmental cardiovascular pathologies
Congestive heart failure
Nonbacterial thrombotic endocarditis
Cardiac arrhythmias
Congestive heart failure is a __ (explain)
system complex not a disease
- inability of the heart to pump blood sufficiently
- volume overload as a result
- develops when the body cant compensate for volume overload or inadequate tissue perfusion
4 causes of congestive heart failure
decreased myocardial function or cardiac valvular dysfunction
Increased vascular resistance
Increased blood volume
Excessive metabolic demand
Systolic vs diastolic heart failure
systolic - reduced contractility
Diastolic - impaired relaxation + abnormal filling
Which cause of congestive heart failure involves hypertension
increased vascular resistance
What is the most common cause of congestive heart failure? Due to what ?
decreased myocardial function or cardiac valvular dysfunction
Previous MI
aortic valve disease vs stenosis
Congenital heart defects / aortic valve disease = Decreased function
Aortic valve stenosis = increased vascular resistance
Chronic renal failure/ kidney disease can lead to
increased blood volume
anemia and thyrotoxicosis can lead to
excessive metabolic demand
Most common cause of CHF
left ventricular systolic dysfunction (Previous MI most common cause)
Left vs right sided heart failure
Left sided = failure of left ventricle or increased pressure in left atrium
Right sided = failure of right ventricle or increased pressure in right atrium
S3 gallop can occur in
left sided heart failure
Dyspnea, orthopnea, cough, hemoptysis –> pulmonary edema
Left sided heart failure
Hemosiderin-laden alveolar macrophages
“heart failure cells”
causes what you cough up to be a rust color
Involved in L sided heart failure
Cor pulmonale is also a cause of
right sided hart failure
Pitting edema in extremities
Right sided heart failure
Biventricular failure
usually not simultaneous but develops over time die to increased stress placed on remaining ventricle
Backward vs forward failure
backward = venous congestion / “damming up” –> left sided
Forward = decreased cardiac output or failing ventricle = inadequate organ perfusion –> right sided
Enlarged or tender liver and spleen
right sided / forward failure
symptoms = anorexia, vomiting, decreased tissue mass
forward heart failure
cardiac pump function =
ejection fraction
= 100 X SV / EDV
EF is measured only in the
left ventricle
Normal EF? Systolic dysfunction?
Normal = .5 (50%) to .7(70%)
Systolic dysfunction = less than or equal to .4(40%)
Most CHF patients have EF below __ but you can have symptomatic CHF with __
50%
normal EF (heart failure with preserved EF)
Cardiac abnormalities and lung abnormalities seen with left sided involvement
Left ventricle = hypertrophied or dilated (fibrosis microscopically)
Lungs = heavy and boggy due to pulmonary congestion and edema. Microscopically we see edema, RBC’s and heart failure cells