Heart Disease Flashcards
What is a common kind of circulatory failure?
Chronic (congestive) heart failure (CHF)
With the onset of heart failure, __________________ are activated in order to maint adequate blood flow
Compensatory mechanisms
Ventricular dilation, myofiber hypertorphy and activation of neurohumoral mechanisms are examples of what
Compensatory mechanisms
__________ improves contraction by stretching the myofibers according to Frank Starling mechanisms
Ventricular dilation (compensatory mechanism)
_________ is associated with the heart’s decreased ability to maintain minimum levels of output and therapy may be required for cardiac survival
Decompensation
An increase in blood volume leads to what kind of hypertrophy of myocardium?
Left ventricular
Pathologic hypertrophy leads to ____________ while “physiologic” hypertrophy ____________
Anatomical and physiological changes that compromise cardiac function; seems to have little ill effect
What is the most common cause of CHF?
Left side ventricular failure
Causes of left side ventricular failure (3)
1 - Coronary heart disease (ischemic heart disease)
2 - Systemic HTN
3 - Aortic and mitral valve disease
Symptoms of left side ventricular failure (2)
1 - pulmonary congestion
2 - reduced output
Or, “backward failure” and “forward failure”
Symptoms of pulmonary congestion?
- breathless when lying down
- rusty sputum
- pleural effusion
Pulmonary congestion, “backward failure”
Symptoms of reduced output?
Low cardiac output leads to
- decreased arterial perfusion
- systemic hypoxia
Reduced output, “forward failure”
_______ ___________ contributes to pulmonary HTN and RIGHT ventricular failure but develops in the absence of left ventricular failure.
Mitral stenosis
Outline the steps of left ventricular failure
Low output
Systemic hypoxia
Overfilling of left atrium leading to:
- pulmonary HTN and edema
Can also then lead to right ventricular failure (AKA combined failure)
Outline the steps of RIGHT ventricular failure
Overfilling right atrium
Increased central venous pressure
Overfilling systemic veins and capillaries
Chronic venous congestion, systemic edema with cyanosis leading to
- Reduced output to lungs
_____________ is characterized by chronic congestion of systemic veins, systemic edema and cyanosis
RIGHT ventricular failure
Including: jugular veins, congestion and distension of liver
List contributing causes of RIGHT ventricular failure (2)
- left heart failure (most common)
- diseases of lung and pulmonary arteries (because lung diseases restrict blood flow through lungs)
Disease of lung and pulmonary arteries can cause right ventricular failure. Examples include
Chronic bronchitis Emphysema Silicosis Cystic fibrosis Severe kyphoscoliosis
Fullness of neck and abdomen (from subQ edema) and a nutmeg pattern on the liver suggests
RIGHT ventricular failure
What are the major heart diseases (4) that (nearly) all lead to CHF?
1 - Ischemic heart disease (most common)
2 - Systemic HTN heart disease
3 - Pulmonary HTN
4 - Congenital heart disease
What are the 4 variants of ischemic heart disease (IHD)?
1 - chronic ischemic heart disease
2 - angina pectoris
3 - myocardial infarction
4 - sudden cardiac death
What type of ischemic heart disease (IHD) is characterized by progressive myocardial atrophy and fibrosis from artherosclerotic disease with fixed (stable plaques) coronary artery stenoses?
Chronic ischemic heart disease (CIHD)
What is the most common symptom of IHD that is characterized by pain of myocardial ischemia WITHOUT infarction (but still increased risk)?
Angina pectoris
Deep paroxysmal pain in precordial region that lasts <30 minutes and may be relieved by rest or administration of nitrites
“Angina”