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Q2 Physio test 3 > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

Heart failure caused by any condition that does what?

A

↓ efficiency of myocardium thru damage or overloading

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2
Q

Physiological definition of HF

A

heart unable to pump at required rate for metabolizing tissues OR has to use elevated filling pressure to do so

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3
Q

Clinical definition of HF

A

abnormalities of L vent fxn and neuorhormal regulation accompanied by:
effort intolerance
fluid retention
reduced longevity

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4
Q

Goal of cardiovascular system is?

A

maintain CO

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5
Q

Consequences of ↓ CO? (2)

A

hypoperfusion of organs

exercise intolerance

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6
Q

Consequences of left failure?

A

↑ L atrial pressure ->

pulmonary congestion and dyspnea

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7
Q

Consequences of right failure?

A

↑ R atrial pressure ->
systemic congestion
LE edema

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8
Q

Life expectancy w/ L vent failure?

A

5 yrs

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9
Q

HTN causes what kind of overload?

A

pressure overload

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10
Q

Valvular disease causes what kind of overload?

A

pressure and volume overload

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11
Q

MI causes what kind of dysfxn?

A

regional

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12
Q

Cardiac dyfxn characterized by? (4)

A

↑heart size and mass
adnorm proteins
fibrosis
inadequate vasculature

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13
Q

Depression of contractility leads to?

A

↓ length-tension curve:

ejection of ↓ SV at same EDV

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14
Q

Symp NS compensation for ↓ contractility?

A

can stim ↑ contractility but not back to normal levels,

eventually SNS is exhausted

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15
Q

Symp NS becomes depressed when what happens (3)?

A

1) ↓ cardiac NE stores
2) ↓ β-adrenoceptor denisty
3) ↓ catecholamine sensitivity

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16
Q

Physio basis for ↓ contractility? (3)

A

1) impaired Ca2+-induced Ca2+ release
2) fiber-type changes
3) ↓ Ca2+ sensitivity

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17
Q

Kidney tries to compensate for ↓ CO how?

A

retains H2O to cause ↑ in blood volume ->

↑ EDV

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18
Q

Final signs of HF: contractility?

A

contractility significantly decreased, SNS no longer able to compensate

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19
Q

Final signs of HF: SV?

A

no longer able to maintain SV

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20
Q

Final signs of HF: stretch?

A

mm fibers stretched beyond optimal length

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21
Q

Final signs of HF: EDV?

A

increased EDV no longer effective

22
Q

Forward failure caused by?

A

inadequate SV

23
Q

Backward failure caused by?

A

blood back-up in venous system ->

congestive HF

24
Q

Eccentric hypertrophy is?

A

↑ mm mass where vent gets longer/bigger, not thicker (adds sarcomeres)

25
Q

Eccentric hypertrophy caused by?

A

volume overload:
vents dilate ->
regurg and ↑ diastolic P ->
↑ mm mass

26
Q

Concentric hypertrophy is?

A

↑ mm mass where walls get thicker (∆ in ratio of contractile proteins to mitochondria)

results in smaller chambers

27
Q

Concentric hypertrophy caused by?

A

pressure overload:
chronic SNS stim ->
↑ contractility ->
SNS exhaustion

28
Q

1st step in L vent failure?

A

L vent weakens -> ↓ emptying

29
Q

2nd step in L vent failure?

A

↓ CO to system

30
Q

3rd step in L vent failure?

A

↓ renal blood flow ->
stim renin-angiotension/aldosterone secretion (fluid retention)

this is postive-feedback loop

31
Q

4th step in L vent failure?

A

blood back-up in pulmonary vein ->

↑ P in pulmonary capillaries

32
Q

5th step L vent failure?

A

↑ P in pulmonary capillaries ->

pulmonary congestion/edema

33
Q

High pulmonary arterial pressure from L vent failure can lead to what effect on R heart?

A

↑ afterload in R vent

Ѧ R vent failure

34
Q

L vent failure causes edema where?

A

pulmonary

Most common = CHF

35
Q

R vent failure causes edema where?

A

peripheral

36
Q

1st step R vent failure?

A

R vent weakens -> ↓ emptying

37
Q

2nd step R vent failure?

A

↓ CO to system

38
Q

3rd step R vent failure?

A

↓ renal blood flow ->

stim renin-angiotension/aldosterone secretion (fluid retention)

39
Q

4th step R vent failure?

A

blood back-up in systemic circ (vena cava) ->
↑ venous P ->
↑ capillary P

40
Q

5th step R vent failure?

A

↑ capillary P ->

edema in LE, liver, abdominal organs

41
Q

6th step R vent failure?

A

venous P now extremely ↑ ->

distended neck vein and cerebral edema

42
Q

Shock is result of what?

A

failure of CVS to adequately perfuse tissues ->

impaired oxygenation and cell metabolism

43
Q

Shock progresses to?

A

hypotension, organ failure and death

44
Q

Cardiogenic shock is result of?

A

↓ myocardial fxn

45
Q

Hypovolemic/hemorrhagic shock is result of?

A

↓ blood volume

bleeding, diarrhea, vomiting, burns

46
Q

Vasogenic (vessel produced) shock is result of?

A

vasodilation from:

1) anaphylactic rxn (peripheral vasodi)
2) septic (massive vasodi)

47
Q

Neurogenic shock is result of?

A

inhibited symp vasoconstrictor nerves ->

loss of vascular tone

48
Q

Common final event of all types of shock is?

A

hypoxia

49
Q

Hemorrhagic Shock specifically due to?

A

fall in arterial pressure (MAP) from massive blood loss

50
Q

Compensatory response to Hemorrhagic Shock?

A

Baroreceptor reflex -> ↑ SNS:
↑ HR, contractility, TPR, venoconstriction, shunting blood from skin to organs

RAS:
↑ angiotensin II and aldosterone

ADH release

51
Q

Result of Irreversible Shock?

A

body can’t compensate ->
severe vasoconstriction of essential beds
(brain, heart, renal)

Q2 Physio test 3 (8 decks)

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