Diastolic Dysfunction Lecture Powerpoint Flashcards
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Diastolic Heart failure is also known as…
…heart failure with preserved ejection fraction (HFPEF)
Diastolic dysfunction is ____ most commonly in patients
Asymptomatic
Young patients are likely to experience ____ type of heart failure, while older patients are likely to experience ____
systolic, diastolic
Diastolic heart failure symptoms (5)
- dyspnea***
- pulmonary edema
- left sided heart failure symptoms
- Elevated BNP
- Evidence of increased ventricular wall thickness on echo
Diastolic heart failure causes (3)
- chronic hypertension** with LVH
- Aortic stenosis with LVH
- ischemic heart disease
Diastolic dysfunction is a source of….
…..atrial fibrillation, atrial fib is poorly tolerated in diastolic heart failure (diastolic heart failure does not tolerate tachycardia well)
Diastolic heart failure involves a ____ ventricle, and has a drop in ____ because of decreased ____
Stiff (noncompliant), stroke volume, end diastolic volume
Diastolic dysfunction definition
Abnormal cardiac relaxation, filling, or distensibility resulting in elevating filling pressure being needed to achieve normal ventricular filling (to normal EDV), often done thru the RAAS
Differential diagnosis of diastolic heart failure (3)
- obesity
- lung disease
- volume overload
Physical exam finding of diastolic heart failure
S4
Laboratory studies for diastolic heart failure (4)
- Echo***
- BNP
- EKG (LVH, left atrial hypertrophy)
- CXR
1 drug treatment for hypertension
ACEI
It is important not to use ____ in treating systolic heart failure, but can use them in diastolic heart failure
Non-hydropyridine Ca2+ channel blockers
Cardiomyopathy definition
General term indicating disease of cardiac muscle resulting in abnormal function not due to hypertension, ischemic disease, or valvular disease
Ischemic cardiomyopathy
A pseudocardiomyopathy that is the leading cause of heart failure in developed countries
List the true cardiomyopathies (4)
- dilated (ventricular dilation)
- hypertrophic (myocardial hypertrophy)
- Restrictive (impaired filling due to fibrosis)
- Arrhythmogenic right ventricular (uhh skip this)
Dilated cardiomyopathy
Most common true cardiomyopathy, characterized by dilation and impaired systolic function of right or left ventricle globally, 50% of cases unknown etiology, others include viral infection or familial inheritance
Dilated cardiomyopathy clinical features (4)
- both R/L heart failure
- arrhythmia
- thrombus
- S3
Dilated cardiomyopathy treatment options (5)
- B blockers
- ACEI
- Diuretics
- Cardiac resyncronization therapy
- Transplant
Hypertrophic cardiomyopathy
Unexplained myocardial hypertrophy disproportional to hemodynamic load with disarray of muscle fibers, inherited in most cases, most common cardiovascular cause of death in athletes
Hypertrophic cardiomyopathy differs from left ventricular hypertrophy in that….
….it is disproportional to hemodynamic load and asymmetrical
Hypertrophic cardiomyopathy clinical features (4)
- dyspnea
- chest pain
- syncope
- sudden death
Hypertrophic cardiomyopathy diagnostic studies (2)
- echo is diagnostic
- EKG
Hypertrophic cardiomyopathy treatment options (3)
- automatic implantable cardioverter defibrillator (AICD)
- Myectomy
- Catheter directed alcohol ablation