Heart Failure Flashcards
what are the characteristics of heart failure
- reduced exercise capacity from decreased CO
- passive congestion of organs/cavitary effusion
what are the five compensatory mechanisms used by the heart
- frank starling
- sympathetic NS
- vasoconstriction
- renal Na/water retention
- cardiac hypertrophy
which compensatory mechanisms are maladaptive
sympathetic NS
vasoconstriction
renal Na/water retention
cardiac hypertrophy
main sign of left sided CHF
pulmonary edema
mechanism of L-CHF signs
blood backs up from LV into LA –> pulmonary veins –> lungs
leads to:
- pulmonary edema
- LA dilation
- increased pulmonary artery pressure
what causes fluid to move out of vessels to cause pulmonary edema
increased hydrostatic pressure from congestion in lung capillary beds
lymphatics are unable to drain sufficiently
clinical signs of L-CHF
- decreased CO and poor perfusion
- gray/muddy MM, prolonged CRT, weak pulses, cool periphery - pulmonary edema
- tachypnea, dyspnea, orthopnea, crackles, cough - pleural effusion (cats)
how to diagnose L-CHF
radiographs: interstitial infiltrate causing increased lung opacity
POCUS: hyperechoic B lines radiating from visceral/parietal surface
what are hyperechoic B lines
bright white lines radiating down from the visceral/parietal interface
gliding = normal but should be minimal bright lines
main sign of R-CHF
systemic congestion
- hepatomegaly
- jugular distention
- cavitary effusion (ascites, pleural effusion, peripheral edema)
mechanism of R-CHF signs
blood backs up from RV into RA –> cr/cau vena cava –> liver –> abdomen
species variations in what type of cavitary effusion
clinical signs of R-CHF
- decreased CO and poor perfusion
- gray/muddy MM, prolonged CRT, weak pulses, cool peripheral - increased systemic vascular pressure
- jugular vein distention and pulsation, abdominal distention
diagnosis of R-CHF
POCUS: anechoic fluid in abdomen/pleural space, dilated vena cava and hepatic veins
ballottement: pressing on one side of the abdomen with one hand and feeling for fluid transmission to the other side
jugular distention/pulsation: check for pulsating or distended jugular above 1/3 of the neck
biventricular dysfunction
signs of both R and L sided heart failure
L-CHF on radiographs
- enlarged LA
- enlarged pulmonary veins
- pulmonary infiltrate
(dogs - perihilar and caudodorsal; cats - dorsal or ventral and patchy)
