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Pathophysiology > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

preload

A

volume entering ventricles

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2
Q

afterload

A

resistance left ventricle must overcome to circulate blood

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3
Q

signs and symptoms of heart failure

A
  • exertional dyspnea/exercise intolerance
  • fatigue, weakness/tiring easily
  • orthopnea: SOB in supine
  • paroxysmal nocturnal dyspnea: SOB at night
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4
Q

common clinical signs of heart failure

A
  • fluid retention
  • ascites
  • jugular venous distension
  • hepatomegaly
  • pitting edema
  • tachycardia
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5
Q

classification of heart failure

A
  • right vs left sided heart failure
  • congestive heart failure
  • HFpEF vs HFrEF
  • functional classification (NYHA)
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6
Q

left sided heart failure

A
  • reduced contractility

- decreased LV stroke volume & LV ejection fraction

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7
Q

impact of left sided failure

A
  • reduced stroke volume, EF and cardiac output
  • blood flow to the body is reduced –> decreased O2 delivery
  • fatigue
  • exercise intolerance
  • SOB
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8
Q

causes of left sided failure

A
  • uncontrolled HTN
  • CAD
  • arrhythmias
  • history of MIs
  • diabetes
  • congenital heart disease
  • cardiac valve disease
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9
Q

results of left sided heart failure

A
  • vascular congestion
  • pulmonary congestion
  • pulmonary edema
  • hemoptysis
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10
Q

what does reduced contractility lead to

A

increased LV EDV and increased LV EDP

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11
Q

is blood movement decreased or increased from the left atrium into the left ventricle during ventricular diastole, and why?

A
  • decreased

- due to an increased left ventricle end diastolic volume

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12
Q

due to the decreased blood movement from the left atrium into the left ventricle, what happens

A

blood accumulates in left atrium causing an increase in left atrium diastolic pressure

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13
Q

signs and symptoms of left sided heart failure

A
  • SOB
  • dyspnea
  • orthopnea
  • fatigue
  • exertional dyspnea
  • waking up feeling like you are suffocating
  • cough
  • mitral valve develops regurgitation
  • decreased urine production
  • restlessness, confusion
  • cyanosis
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14
Q

what does DO CHAP stand for

A
  • for left sided heart failure
  • Dyspnea
  • Orthopnea
  • Cough
  • Hemoptysis
  • Adventitious breath sounds
  • Pulmonary Congestion
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15
Q

right sided failure

A
  • contractility of right ventricle is reduced

- doesn’t pump efficiently

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16
Q

impact of right sided heart failure

A

accumulation (congestion) of blood in right ventricle and atrium and in the systemic circulation, resulting in systemic S&S

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17
Q

signs and symptoms of right sided failure

A
  • congestion in the systemic circulation
  • abdominal blotting/swelling/ascites
  • kidney failure
  • JVD
  • weight gain
  • dependent edema
  • increased fq of DVT and PE’s
18
Q

congestive heart failure

A
  • heart is unable to pump enough blood to meet metabolic needs
  • causes pathological change in the myocardium
  • most common
19
Q

when do symptoms arise in CHF

A

not until decompensated CHF and exercise capacity declines

20
Q

class 1 heart failure

A
  • cardiac disease
  • no limitation of PA
  • no symptoms
21
Q

class 2 heart failure

A
  • mild symptoms
  • slight limitation of PA
  • comfortable at rest
  • ordinary activity may cause symptoms to flare
22
Q

class 3 heart failure

A
  • marked limitation of PA
  • comfort at rest
  • less than ordinary activity
23
Q

class 4 heart failure

A
  • severe limitation

- symptoms even at rest

24
Q

stage A HF

A

people at high risk for developing HF in the future but no functional or structural heart disorder, pre-heart failure

25
Q

stage B HF

A

structural heart disorder but no symptoms at any stage

26
Q

stage C HF

A

previous or current symptoms of HF in the context of an underlying structural heart problem, managed with medical treatment

27
Q

stage D HF

A

advanced disease requiring hospital-based support, heart transplant or palliative care

28
Q

acute HF

A
  • symptoms appear suddenly or a rapid worsening of existing symptoms of HF occurs
  • exacerbation
29
Q

what is the 5lb rule

A
  • a 5 lb increase in body weight in 24 hrs

- this increases risk for exacerbation

30
Q

systolic HF

A
  • heart failure with reduced ejection fraction, HRrEF

- left ventricular contractility is reduced in turn reducing EF and O2 delivery

31
Q

what is the net effect of systolic HF

A

reduced delivery of blood into systemic circulation and subsequent O2 delivery

32
Q

diastolic HF

A
  • heart failure preserved ejection fraction, HFpEF
  • ventricles are limited in filling, become stiffer and less compliant
  • reduced stroke volume
33
Q

systolic HF or HFrEF is preceded by:

A
  • chronic comorbidities
  • more men than women
  • frequent hospitalization
34
Q

diastolic HF or HFpEF is preceded by:

A
  • chronic comorbidities

- more women than men

35
Q

cardiac remodeling

A
  • negative, heart failure
  • ventricular dilation
  • thinning of ventricular walls
36
Q

what are the subcellular changes in cardiac remodeling?

A
  • reduced mitochondrial density
  • diruption of myofibrils
  • disruption of normal anatomy of the sarcomeres
  • disruption of sarcolemma
  • fibrosis
37
Q

what do the subcellular changes in cardiac remodeling result in?

A
  • cardiac dysfunction of HF

- marks the transition from cardiac hypertrophy (compensated) to heart failure (decompensated)

38
Q

what is HF a response of

A
  • long term hyperautonomic and/or chronic hyperinflammatory state
39
Q

what are other things that HF can cause damage to?

A
  • endothelial dysfunction
  • skeletal muscle damage
  • decreased systemic blood flow & increased total peripheral resistance
  • kidney dysfunction
  • cachexia
40
Q

what is a key intervention for people with HF

A

exercise training

Pathophysiology (17 decks)

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