heart failure Flashcards
What is the definition of heart failure
A complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ventricle in filling with or ejecting blood
What is the rate of mortality of heart disease?
50% mortality rate in the first 5 years of diagnosis
What are examples of restrictive pathologies
Restrictive cardiomyopathy
Constrictive pericarditis
Tamponade
Hypertrophic cardiomyopathy
Mitral stenosis
Tricuspid stenosis
What are the pathologies of heart failure?
Restrictive filling
Pressure overload
Volume overload
Contractile impairment
Arrhythmias
What are examples of pressure overload (afterload)?
Hypertension
Aortic stenosis
Pulmonary embolism
Pulmonary hypertension
Pulmonary stenosis
What are examples of contractile impairment
Ischemia
Dilated cardiomyopathy
Myocarditis
What are examples of volume overload (preload)?
Mitral regurgitation
Aortic regurgitation
Pulmonary regurgitation
Tricuspid regurgitation
Shunts
What are 3 forms of high output heart failure?
Anemia
Hyperthyroidism
Beriberi
What is the definition of cardiomyopathy?
Disease of the heart muscle
What can cause cardiomyopathys?
Ischemia
Hypertension
Disorders that are inherited
Infections
Toxins
Myocarditis
Autoimmunities
What are the three patterns of cardiomyopathies?
Dilated
Hypertrophic
Restrictive
How does the heart respond to dilated cardiomyopathy?
Heart muscle gets larger, adds more sarcomeres
Left ventricle becomes bigger but thinner
How does the heart appear if the dilated cardiomyopathy is genetic?
The left ventricle grows rounded
Fibrous
HFrEF
What lifestyle choices can lead to dilated cardiomyopathy?
Toxins such as alcohol
How is dilated cardiomyopathy diagnosed?
Chest radiograph
Echocardiogram
How can dilated cardiomyopathy be managed?
Diuretics
Inotropic agents
What portion of the heart is affected in genetically induced hypertrophic cardiomyopathy?
The septal walls thicken
What do inotropic agents
Enhance contractility
What does increased afterload do to the myocardium?
Increases thickness of the heart wall
What is the effect of afterload on cardiac output?
Increased muscle mass of the myocardium results in the heart being able to push against a larger afterload
Increased muscle mass reduces the volume of blood that the ventricle is able to hold
What is the most common inherited cardiac disorder?
Hypertrophic cardiomyopathy
How are restrictive cardiomyopathies tested for and treated?
Myocardial biopsy
Treat underlying pathology
What can happen if the septum hypertrophies to an extreme level?
The ventricular septum can block the aortic valve
How is hypertrophic cardiomyopathy diagnosed?
Echocardiography
Cardiac catheterization
What is happening in restrictive cardiomyopathy?
Wall thickness and systolic function are normal
Muscle is stiff
What can cause restrictive cardiomyopathy?
Appears idiopathically
Appears as cardiac manifestation of systemic disease
Describe amyloid cardiomyopathy
Amyloidosis causes proteins to misfold and form fibrils that collect and inhibit muscle function resulting in decreased compliance of the myocardium
What does restrictive cardiomyopathy cause?
Impedes ventricular filling
Raises pressure during diastole
