heart failure Flashcards
2 core elements of heart failure
- heart too weak
2. heart too stiff
risk of heart failure
1 in 5
** name of heart too stiff
impaired diastolic filling (small cup)
name of heart too weak
impaired contraction (floppy cup)
4 features of stiff heart
- normal systolic function
- normal LV size
- thickened walls
- concentric hypertrophy
3 features of weak heart
- low LV ejection fraction
- dilated LV
- eccentric hypertrophy
5 places heart failure can occur from and most common
- cor. arteries -MI - most common
- myocardium - cardiomyopathies
- endocardium - stenosis
- pericardium
- systemic
what are stages of HF
- Normal heart > injured
- early dysfunction > neurohormonal activation
- perisitannt dysfucntion > remodelling
- compensated phase
- decompensated phase - symptoms
- refractory and death
*** how does remodeling occur
- adaptive changes occur to size and structure
- leads to alter geometry - become maladaptive
- neurohormonal activation is key
what would change in remodelling
larger, thicker LV
how does neurohormonal activation start
drop in CO and BP
3 responses to drop in CO and BP
- symp activation
- renin angiotensin system
- vasopressin
what do these responses do?
lead to prgressive remodelling
what occurs in decompensated stage (3)
- high preload
- high afterload
- poor contractility
- leads to onset of symptoms
what is a common consequence of high preload
pulmonary and peripheral edema
4 stages of heart failure
- no limits
- ordinary act. give symptoms
- less than ordinary symptoms give symptoms
- symptoms present at rest
non-medical therapy (4)
- low salt
- low fluid
- daily weight monitor
- supervised excercise
4 drugs that improve symptoms
- diuretics
- inotropes
- vasodilators
- morphine
3 drugs that can help survival
- ACE inhibitors
- Beta blockers
- aldosterone receptor agonists
3 long-term effects of Beta blockers
- decrease death rate
- decrease remodelling
- improve blood pressure
3 other options
- shocking
- pacing
- pumping
