Heart Failure Flashcards
Heart failure
the inability of the heart to maintain sufficient cardiac output to optimally meet metabolic demands of tissues and organs and is the end stage of most cardiac diseases
What is involved in heart failure?
multiple organ systems and a progressive syndrome
What are the results of heart failure?
congestion of blood in the pulmonary venous circulation
Common causes of heart failure
coronary heart disease and hypertension interacting . CAD contributes to HF via endothelial cell dysfunction, ischemia and infarction.
Congestive heart failure
dysfunctional cardiac pumping that results in congestion of blood behind the dysfunctional cardiac pump.
Right-sided failure: systemic venous congestion
Left-sided failure: pulmonary congestion
What contributes to heart failure?
impaired ability of myocardial fibers to contract, relax or both
How is congestive heart failure classified?
systolic or diastolic heart failure
Which patients have a higher mortality rate of death from heart failure?
those with low ejection fraction and congestive symptoms
What are the 4 types of heart failures?
- systolic dysfunction
- diastolic dysfunction
- left-sided heart failure
- right-sided heart failure
Systolic Dysfunction
low ejection fraction due to reduced contractility
What is impaired contractility attributable to?
MI (which is a common cause of heart failure) with cell death and loss of contractile elements reduces the heart’s contractile force
Diastolic dysfunction
the left ventricle is excessively noncompliant and does not fill effectively during diastole
What are the 2 common causes of diastolic dysfunction?
CAD and hypertension
What are the 3 methods to compensate HF in order?
- Increase sympathetic activation
- increase Preload via RAAS
- Hypertrophy
What is the downside of compensatory mechanisms for HF?
over a long period of time can be detrimental to the heart
How does activating the SNS help in an immediate response to acute responses such as volume depletion in the heart?
activation via baroreceptors increase heart rate and contractility and preload
How does increasing preload in reducing HF?
Activating the RAAS( release of aldosterone which causes NA+ reabsorption and water increasing blood volume)
How does hypertrophy aid in HF compensatory?
there is an increase of wall tension which causes hypertrophy this increases the contractile elements in the myocardium increasing the heart’s pumping force and helps to reduce the wall tension of the heart toward normal levels
forward failure
insufficient cardiac pumping is manifested by poor CO( to the body)
backward failure
congestion of blood behind the pumping chamber (to the lungs)
What is left-sided heart failure must associated with?
left ventricular infarction and systemic hypertension
What are the backward effects of left-sided heart failure?
pulmonary congestion and edema( accumulation of of blood is going to cause backflow of blood to the lungs increasing capillary hydrostatic pressure forcing blood in the interstitium) , dyspnea, orthopnea, paroxysmal nocturnal dyspnea and volume expansion from salt and water intake , cyanosis (fluid in the alveoli and interstitial fluid interferes with gas exchange and results in hypoxemia. hypoxemia is detected by arterial blood gas analysis) acute cardiogenic pulmonary edema (basilar crackling)
Acute cardiogenic pulmonary edema
associated with left-sided heart failure with severe gas exchange. Si/SX: dyspnea, anxiety and bubbly crackles
T/F Left ventricle failure eventually increases the workload of the right ventricle so it can also fail. So isolated right ventricle failure is rare
True
