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Medicina forense > Heart failure > Flashcards

Heart failure Flashcards

1
Q

definition of heart failure

A

Insufficient oxygen delivery due to imbalance between the requirements and the needs.

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2
Q

classification according to the ejection fraction

A
  • HFrEF (reduced EF < 40%)
  • HFmEF (midly impaired EF 40-49%)
  • HFpEF (preserved EF ≥ 50%) (mainly characterized by diastolic dysfunction)
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3
Q

classification acording to the time course

A
  • New onset
  • Transient
  • Chronic
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4
Q

other classifications

progression and location

A
  • Progression
    • Acute
    • Stable
    • Worsening
  • Location
    • Left
    • Right
    • Combined
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5
Q

number 1 disease that makes the herat make the most effort

A

Hypertension

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6
Q

at what point of the volume of the ejection fraction is considered heart failure

A

<35

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7
Q

what happens in pulmonary edema

A

Intersticial space gets filled with blood, as the volume stays the same, it manifests as dysnea.

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8
Q

characteritics of Systolic Heart failure SHF

A

Impaired contraction
Can happen to any persona
Caused by coronary artery disease

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9
Q

characteritics of Diastolic Heart failure SHF

A

Impaired filling
Present in >60 yo
Caused by hypertension

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10
Q

diseases that lead to
Left-sided heart failure SYSTOLIC

A
  1. Ischemic heart disease (fibrosis in miocardium, necrosis area wont contract)
  2. Hypertension (miocardiom hypertrophy, coronary compression, higher O2 demand)
  3. Dilated cardiomyopathy (chamber grows, higher preload, higher contraction, weak myocardium)

=
Heart does not pump efficiently through the whole body

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11
Q

diseases that can lead to left-sided heart failure DYASTOLIC

A
  1. hypertension (concentric hypertrophy= less space for filling)
  2. Aortic stenosis (hypertrophy cardiomyopathy)
  3. Restrictive cardiomyopathy (less compliant, unable to stretch and fill)

=
Heart does not FILL efficiently
(here the R-A-A axis activates leading to fluid retention and at the ultimate instance pulmonary circulation gets affected.

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12
Q

Signs and symptoms of pulmonary edema

A
  • orthopnea: Patient won’t be able to breathe while laying down, as blood distributes equally through the lungs
  • crackles
  • pitting edema at the lower limb
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13
Q

diseases that lead to Right-sided heart failure

A
  1. Left-sided HF (congestion in pulmonary veins, more pressure at the pulm artery)
  2. Shunt (concentric hypertrophy, results in ischemia and less volume)
  3. Cor pulmonale (hypoxia, arteriole constricition, elevation of the pulmonary pressure and hypertrophy)

Heart does not pump efficiently

RAA -> fluid retention -> sistemic circulation

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14
Q

Tipical symptoms of HF

6

A
  1. ankle swelling= edema
  2. breathlessness
  3. orthopnea
  4. paroxysmal nocturnal dyspnea
  5. reduced excercise tolerance
  6. fatigue
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15
Q

less typical symptoms

6

A
  1. nocturnal cough
  2. wheezing
  3. bloated feeling
  4. loss of apetite
  5. palpitations
  6. syncope
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16
Q

more specific signs of HF

4

A
  1. jugular ingurgitation
  2. hepatojugular reflux
  3. thrid heart sound
  4. laterally displaced apical impulse
17
Q

less specific signs

A
  1. weight gain (>2 kg/wk)
  2. weight loss in advanced HF
  3. cardiac murmur
  4. peripheal edema
  5. pulmonary crepitations
  6. tachycardia
  7. tachypnea
  8. cheyne stokes respiration
18
Q

classification AHA

A

A high risk but no structural or functional abnormality
B developed structural, without signs or symptoms
C symptomatic associated with structural heart disease
D advanced structural and marked symptoms at rest, despite maximal medical therapy.

19
Q

classification NYHA

A

I. no symptoms. no limitation of physical activity
II. mild symptoms. sligh limitation of physical activity, confortable at rest but ordinary activity results in symptoms
III. moderate symptoms. marked limitation of physical activity, confortable only at rest but less than ordinary activity results in symptoms
IV. severe symptoms. present at rest

Medicina forense (5 decks)

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