heart failure Flashcards
Cardiac output =
stroke volume(L) x heart rate (bpm)
in frank starling, the stroke volume is related to
end diastolic volume
a dysfunctional heart will try to
maintain stroke volume/co by increasing end diastolic pressure/volume
3 ways the body compensates for decreased CARDIAC OUTPUT and systemic BP
1) activate RAAS
2) release vasopressin -
3) activate SNS
what type of hypertrophy does the heart undergo to maintain stroke volume
eccentric
eccentric hypertrophy VS concentric hypertrophy
eccentric - volume overload
concentric - pressure overload
In diastolic HF you have
preserved EF
- concentric hypertrophy
- normal LV size
- increased wall thickness
In systolic HF you have
- reduced EF
- eccentric hypertrophy
- LV dilatation
- normal thickness of the wall
what happens to your stroke volume in systolic dysfunction
- reduced stroke volume
- for the same volume, less pressure
curve shifts right
in diastolic dysfunction - what happens to stroke volume
also reduced by compliance is also reduced - volume is less but pressure is higher
lower line shifts left
2 main reasons for reduced Ejection fraction
coronary artery disease
Htn
2 main reasons for preserved EF
Hypertension most likely cause
Diabetes
drugs that make people feel better
digoxin and diuretics
drugs that improve survival
acei/arbs
beta blockers
aldo antagonists
the central mechanism of progressive HF is
neurohumoral activation
beta blockers are helpful because
decrease rates of sudden cardiac death
decrease LV remodeling
improve BP long-term
decrease MV regurg
when do you treat people with HF with beta blocker and ACEi?
- anyone with eF
patients with symptomatic heart failure and very low ejection fraction should be on
spironolactone
cardiac resychronization is helpful in patients with what type of HF
systolic dysfunction
when are LVADs used?
buy time waiting for a heart transplant
