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Pathophysiology Test 2 > heart failure > Flashcards

heart failure Flashcards

1
Q

what effects CO?

A

-stroke volumes-contractility, Preload, Afteroad
-heart rate

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2
Q

what is the most common decrease in contractility?

A

MI (EDV, SNS stimulation, myocardial o2 supply)

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3
Q

what most commonly effects preload?

A

increases directly with an increase in plasma volume
increases indirectly by a decrease in contractility
(ESV, Venus return)

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4
Q

what most commonly effects after load?

A

increased peripheral vascular resistance
(aortic pressure and aortic resistance)

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5
Q

what is the effect of increased preload have on ccontractility?

A

it increases contractility

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6
Q

how does increased preload increase contractility?

A

increased LVEDV increases the size of the lumen, leading to myocardial ischemia
increased LVEDV causes stretching of the myocardium

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7
Q

what changes in contractility are independent of preload?

A

-calcium channels in heart cells

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8
Q

what is heart failure?

A

the inability of the heart to supply the body and heart muscle with adequate circulatory pressure and volume

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9
Q

what is the acute type of heart failure?

A

MI

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10
Q

what are the chronic forms of heart failure?

A

hypertension,aortic stenosis, ventricular hypertrophy

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11
Q

what is CHF (left)?

A

the inability of the left ventricle to provide adequate blood flow to the heart and other vital organs throughout the systemic circulatory system

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12
Q

what is right side heart failure?

A

the inability of the right ventricle to provide adequate blood flow into the pulmonary circulation

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13
Q

what happens to the EF in systolic heart failure.

A

ejection fraction is reduced

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14
Q

what happens to the EF in diastolic heart failure?

A

EF is preserved

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15
Q

what happens when the heart is stretched too far?

A

contractility is decreased

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16
Q

what is EF?

A

a measurement of the percentage of blood leaving the heart each time it squeezes

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17
Q

what is preload?

A

the force that stretches the cardiac muscle prior to contraction. This force is composed of the volume that fills the heart from venous return

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18
Q

what is after load?

A

the amount of pressure that the heart needs to exert to eject the blood during ventricular contraction. This is recorded as the systolic pressure of the heart

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19
Q

how does hypoxia and acidosis effect contractility?

A

the shape of proteins get denatured, and loose function

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20
Q

what increases after load?

A

when there is an impediment to blood flow out of a chamber

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21
Q

Which chamber has increased afterload due to hypertension?

A

left ventricle

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22
Q

In response to increased afterload, how do cardiac cells adapt?

A

hypertrophy
-larger muscle cells decree the workload (require more o2)
-without increased supply the muscles tissue becomes hypoxic which decreases contractility

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23
Q

if _____ is decreased, the heart chambers don’t empty well

A

contractility

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24
Q

what is the effect on contractility on during an MI?

A

decreased in contractility

25
Q

what does the effect on renal failure have on preload and contractility?

A

it increases preload
and decreases contractility

26
Q

what effect does HTN have on after load?

A

it is increased

27
Q

what does reduced EF and increased LVEDV have?

A

it increases preload

28
Q

what effect does decreased renal perfusion and increased renin-angiotensin have?

A

it increases afterload

29
Q

An impediment to outflow of blood initially increases the ____

A

afterload

30
Q

hypertrophy results in an increased demand for?

A

oxygen

31
Q

what is systole?

A

contraction

32
Q

what is systolic heart failure?

A

Inability to pump blood properly due to poor contractility

33
Q

the inability to pump blood properly due to poor contractility increases and decreases what?

A

increases preload
decreases stroke volume
and reduces stroke volume

34
Q

what is the most common cause of systolic heart failure?

A

CAD

35
Q

what drugs decreases workload on the heart?

A

morphine, nitrates, B-blockers

36
Q

what medications increase contractility?

A

calcium

37
Q

what do the drugs that treat systolic heart failure aim to do?

A

aim to decrease workload on the heart or to increase contractility

38
Q

what is diastole?

A

relaxation

39
Q

what is diastolic heart failure?

A

Chamber fails to fill properly (with enough blood)
decreases blood volume

40
Q

how does the chamber fail to fill properly in diastolic heart failure?

A

heart is not pumping out enough blood

41
Q

what is the response when the heart is not pumping out enough blood?

A

hypertrophy-to decrease volume
the walls then become stiff and non-compliant (harder to stretch)
-the chamber can’t accommodate a normal amount of blood

42
Q

what is a common cause of diastolic heart failure?

A

chronic HTN- induced hypertrophy

43
Q

what’s the treatment for diastolic heart failure?

A

reduce the HR to create more time between contractions and more time to fill

44
Q

what are the causes of right heart failure?

A

pulmonary disease and L heart failure

45
Q

in many pulmonary diseases, the vessels constrict. What effect does this have?

A

increases after load
causes peripheral edema
increases BHP

46
Q

what are the common causes of left heart failure?

A

HTN, valvular disorders
-caues pulmonary edema and increased BHP

47
Q

what are the common causes of left heart failure?

A

HTN, valvular disorders
-causes pulmonary edema and increased BHP

48
Q

Pulmonary edema interferes with normal gas exchange in the lungs leading to?

A

decreased oxygenation in the blood
decreased contraction
blood backs up in the right side leading to R side heart failure

49
Q

what are the symptoms of impaired CO in decompensated heart failure?

A

-rapid wt gain
-increases urine output

50
Q

is there a cure to heart failure?

A

no

51
Q

what do treatments of heart failure aim to do?

A

maximize CO and tissue perfusion and/or reduce the workload of the heart

52
Q

what is most commonly prescribed for heart failure and what do they do?

A

diuretics decrease preload

53
Q

what are all of the heart failure treatments?

A

-diretics
-digoxin
-low-sodium diet
-HTN,ATH,CAD treatments:
ACE inhibitors
Angiotensin II receptor blockers(ARBs)
Beta-blockers
Blood vessel dilators (nitrates)
Aldosterone antagonists
Calcium channel blockers

54
Q

what does digoxin effect?

A

strengthens contractions

55
Q

what does a low-sodium diet effect?

A

less preload which then effects bp lowering afterload

56
Q

what do ARB’s do?

A

Angiotensin 2 causes constriction-inhibits that

57
Q

what do B-blockers cause?

A

vasodilation

58
Q

what do nitrates do?

A

vasodilator-decrease workload on the heart

59
Q

what do Ca-channel blockers do?

A

decrease HR-reduce workload

Pathophysiology Test 2 (10 decks)

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