Heart Failure (2) Flashcards
What is heart failure?
Inability of the heart to eject blood to meet the demands of the body while maintaining normal pressures in its chambers and lungs
What are symptoms of heart failure?
SOB, fluid retention, fatigue, Orthopnea, paroxysmal nocturnal Dyspnea
How many deaths occur due to heart failure?
1 in 9 (most common in > 65 y/o)
What is the most common cause of heart failure?
Ischemic heart disease
When is your lifetime risk for developing heart failure greater?
When BP is > 160/90 mmHg
What are the three main categories of cardiomyopathies?
Dilated, hypertrophic, and restrictive
What is dilated cardiomyopathy?
Increased cardiac mass and dilation of all 4 chambers with no wall thickening (systolic dysfunction)
What is eventually developed in dilated cardiomyopathy?
Left and right ventricular failure
What occurs in hypertrophic cardiomyopathy?
Increase in cardiac mass that may be symmetrical or asymmetrical
What is affected in hypertrophic cardiomyopathy?
Diastolic dysfunction due to abnormal LV relaxation (systolic function is normal)
What is restrictive cardiomyopathy?
Restriction of ventricular filling caused by endocardial or myocardial disease (ventricular walls lose compliance and become rigid)
What is affected in restrictive cardiomyopathy?
Diastolic dysfunction
What is affected in hypertrophic cardiomyopathy?
Diastolic dysfunction
What is affected in dilated cardiomyopathy?
Systolic dysfunction
What is the most common type of cardiomyopathy?
Dilated
What affect does kidneys have on heart failure?
Decreased CO leads to renal sodium and water retention which leads to restoration of organ perfusion which leads to increased vascular resistance
What is the viscous cycle?
Ventricular dysfunction
Decreased CO
Compensations
Excessive vasoconstrictions and Na/water retention
Increased Afterload and excessive preload
What are compensations of the vicious cycle?
Increased SNS
Increased RAS-aldosterone
Increased ADH
What is pre load?
Degree of myocardial distention prior to shortening (depends on amount of ventricular filling)
What is after load?
Force against which the ventricles must act in order to eject blood (dependent on arterial blood pressure and vascular tone)
What is the normal value for ejection fraction?
55-75%
What is most common risk factor of systolic heart failure?
Ischemic heart disease
What is the most common risk factor for diastolic heart disease?
Hypertension
What classifies someone to have heart failure with reduced ejection fraction?
<40% ejection fraction (systolic HF)
