Heart Failure Flashcards
What is chronic heart failure?
This is when the heart is unable to pump a enough blood to meet the metabolic need of the tissue
Physiological mechanism that maintains arterial bp and organ perfusion
- Frank sterling mechanism- increases end-diastolic filling volumes
Increase in ventricular dilation leads to ^ in oxygen requirement of the myocardium - Myocardial adaptation- hypertrophy with or without cardiac chamber dilation ( increase in cardiac muscle with normal size or ^ in the size of ventricle
- Activation of neurohomoral system
DECOMPENSATED HEART FAILURE ?
Failing myocardium no longer propel sufficient blood - DECOMPENSATED HEART FAILURE
compensated heart failure?
If dilated ventricle meets cardiac output- compensated heart failure
Myocardial structure changes?
- Pressure overload (hypertension, valvular stenosis) - new sarcomere are added adjacent to existing sarcomere (concentric hypertrophy) - no increase in size of the heart but ventricular thickness
- Volume overload (valvular regurgitation)- new sacromere are added in series with existing sacromere , length ^, ventricle dilates, thickness <>=
Two types of heart failure?
Left and right
Causes of Left-sided HF?
IHD (atherosclerosis)
SYSTEMIC HYPERTENSION
MITRAL OR AROTUC VALVE DISEASE
DISEASE OF THE MYOCARDIUM (amyloidosis)
Effect of left sided HF
Reduced systemic perfusion
Elevated back pressure in the lungs
Affects heart and lungs.
Morphology of left sided HF
Heart- ventricular hypertrophic Mitral valve stenosis Myocyte hyperthrophy Atrial fribilation Interstitial fibrosis Lungs- pressure in pulmonary veins Congestion and edema Pleural effusion Heavy and boggy Perivascular and interstitial transudates Alveolar edema RBc extravasate from capillaries to the alveol Heart failure cells