Heart Failure Flashcards
What is heart failure?
Clinical syndrome which refers to a state of reduced cardiac output
What is the heart unable to do in someone with heart failure?
Unable to pump enough blood to meet the metabolic needs of the body
What are the two forms of heart failure?
Reduced left ventricular ejection fraction
Preserved left ventricular ejection fraction
How is ventricular ejection fraction measured?
Echocardiogram
How is reduced LVEF defined?
< 35 to 40%
What do people with reduced LVEF usually have?
systolic dysfunction
What is systolic dysfunction?
Impaired left ventricular contraction during systole
Which conditions cause systolic dysfunction?
- Ischaemic heart disease
- Dilated cardiomyopathy
- Myocarditis
- Arrhythmias
What do people with preserved LVEF usually have?
diastolic dysfunction
What is diastolic dysfunction?
Impaired ventricular filling during diastole
Impaired ventricular relaxation
Which conditions cause diastolic dysfunction?
- Hypertrophic obstructive cardiomyopathy
- Restrictive cardiomyopathy
- Cardiac tamponade
- Constrictive pericarditis
What is acute cardiac failure?
An acute exacerbation of chronic heart failure
What are the most urgent symptoms due to?
Ventricular failure
What does ventricular failure usually result in?
Pulmonary oedema
What does left ventricular failure usually lead to?
Pulmonary oedema
What symptoms does pulmonary oedema cause?
- dyspnoea
- orthopnoea
- paroxysmal nocturnal dyspnoea
- bibasal fine crackles
What does right ventricular failure usually result in?
- peripheral oedema- ankle/sacral oedema
- raised jugular venous pressure
- hepatomegaly
- weight gain due to fluid retention
- anorexia (‘cardiac cachexia’)
What type of situation is acute heart failure?
Life-threatening emergency.
What is acute heart failure?
Sudden onset or worsening of the symptoms of heart failure.
How can acute heart failure present?
With or without a background history of pre-existing heart failure.
What is acute heart failure presenting without a past history of heart failure called?
De-novo AHF.
What is acute heart failure presenting with a past history of heart failure called?
Decompensated AHF
What is De Novo AHF due to?
Ischaemia.
How does ischaemia result in de novo AHF?
It causes reduced cardiac output and therefore hypoperfusion
—Pulmonary oedema
What are the most common precipitating causes of acute cardiac failure?
- Acute coronary syndrome
- Hypertensive crisis
- Acute arrhythmia
- Valvular disease
How are patients with heart failure broadly categorised?
- With or without hypoperfusion
- With or without fluid congestion
What are the main symptoms of heart failure?
- Breathlessness
- Reduced exercise tolerance
- Oedema
- Fatigue
What are the main signs of heart failure?
- Cyanosis
- Tachycardia
- Elevated JVP
- Displaced apex beat
- bibasal crackles
- S3-heart sound
What heart sounds may present in someone presenting with heart failure?
S3 heart sound
Displaced apex beat
What does impaired left ventricular functioning cause?
Causes build up of blood in the left atrium
This results in blood backing into the pulmonary vessels–> pulmonary oedema
