Heart Failure Flashcards
What is Heart failure?
Complex clinical syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood
-Also known as congestive heart failure (CHF) or chronic heart failure
Etiology of Heart Failure
4
- Overworking of heart
- Less blood flow to heart
- genetic problems
- Blood flow problemss
- Common final stage for many diseases
___________ is a common final stage for many diseases of the cardiovascular system
Heart Failure
Pathophysiology of Heart Failure
- Overgrowth of heart
- Increased Cardiac Output, from Adrenergic Activation : Contractility, and Heart Rate
- Abnormal Ca++ cycling
- Renin Angiotensin Aldosterone system
- Cell Death
- Genetics
- Other
What is Pathophysiology?
the disordered physiological processes associated with disease or injury.
What pathophysiologys increase with age?
- Increases in epicardial fat
- Change in Left Ventricular Cavity
- Calcification and damages to mitrial and aortic valves
- Atrial Arrhythmias
- Aortic Stiffening
- Increases in Collagenized connective tissure
- Increases in atherosclerosis
What are the two types of Heart Failure?
HFrEF - aka Systolic Heart Failure
HFpEF - aka diastolic Heart Failure
What is HFrEF
What are the problems with this?
Heart Failure Reduced Ejection Fraction
Systolic Heart Failure
Reduced Ejection Fraction (Ejects less than 40% normal volume)
-LV cavity is dilated, wall is lengthened, thin
-Impaired contractility
-Reduced tissue perfusion
What is HFpEF
What are the problems with this
Heart Failure Preserved Ejection Fraction
Diastolic Heart Failure
Ventricle does not fill with blood well in the relaxation phase.
-LV is abnormally stiff, thick
-Impaired relaxation during diastole
-Unable to increase output in response to demands
-More common in women
What does a heart with HFrEF look like?
It has thin walls because it is unable to pump the blood out
What does a heart with HFpEF look like?
It has thick walls due to build up muscle and fat
Types of Left sided heart failure?
Systolic HF and Diastolic HF
Types of Right Sided Heart Failure?
What happens from this?
Commonly caused by left side Pulmonary Hypertension Pressure and congestioon in veins and capillaries -Vein enlargement -liver enlargement -edema in ankles
Why is HFpEF called backward failure?
It causes a back up in the pulmonary and peripheral back up
Why is HFrEF called forward failure?
It cause more heart stress and passes thing onward that causes problems such as hypertension
What are symptoms of Heart Failure?
4
- Dyspnea- difficulty breathing
- Fatigue
- Decreased Exercise Tolerance
- Orthopnea-difficulty breathing lying down
What are tests that can be done to determine Heart Failure?
6
- Check Vital Signs
- Check volumes (edema, weight JVP-Jugular Venous Pressure)
- Blood work, for biomarkers
- Electrocardiogram
- Chest X Ray
- Echocardiogram
Statistics about Heart Failure
About 5.8 million people in the US
Contributes to 1 in 9 deaths
About 50% mortality within 5 years of diagnosis
Which ehtnic group has higher prevalence of HF
Blacks, whites
Risk factors for Heart Failure?
Name a few
Hypertension Coronary artery disease Acute coronary syndrome (ACS)- MI, unstable angina Arrhythmias Impaired renal function Diabetes Viral infections Age (>65) Male African American Obesity Metabolic syndrome Alcohol use Some chemo drugs Tobacco
ACCF/AHA Stages/classes of HF
List em 4
A- At high risk but without structural heart disease or symptoms of HF
B- Structural heart disease but without signs or symptoms of HF
C-Structural heart disease with prior or current symptoms of HF
D- Refractory HF requiring
NYHA Functional Classification
List em 4
I – No limitation of physical activity. Ordinary physical activity does not cause symptoms HF
II – Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in symptoms of HF
III – Marked limitation of physical of physical. Comfortable at rest, but less than ordinary activity causes symptoms of HF
IV – Unable to carry on any physical activity without symptoms of HF, or symptoms of HF at rest.
What should someone do at Stage A
-Which guidelines
ACCF/AHA Treatment Guidelines -Control HTN and lipid disorders according to guidelines By controlling -obesity -diabetes -Tobacco -Other Cardiotoxins
What should someone do at Stage B
-Which guidelines
ACCF/AHA Treatment Guidelines Take an -ACEI or ARB (Hx MI, reduced EF) -Beta blockers (Hx MI, reduced EF) -Statins (Hx MI) or even have -Implantable cardioverter-defibrillator (ICD) in some patients
