Heart Failure Flashcards
where does blood pool during L sided congestive heart failure?
venous blood pools upstream of lungs (pulmonary veins, venues, alveolar septal capillaries)
Where does blood pool during R sided congestive heart failure
venous blood pools upstream in the CrCV and CaVC and their venous tributaries, in veins and capillary beds of splanchnic viscera and dependent areas
Where is passive congestion most obvious in R sided heart failure
liver
Sinusoids will be distended w/ blood, degeneration, necrosis periportal/ midzonal
The mitral valve can be auscultated where on the L chest wall?
4-5th intercostal space
What parameters do we use to assess cardiac structure and function on a chest radiograph?
Artery diameter
Cardiac length/ width vs thoracic cavity
Trachea angle, if parrallel to spine, cardiomegaly
Contact with sternum
What does long axis echocardiagraphy assess
visualisation or chambers LA, LV e.g. and valve function
what can colour doppler be applied to echocardiography to show?
turbulent flow during systole
What does short axis echocardiography assess
L ventricular internal diameter (LVID) at diastole and systole
What does short axis, M-mode echocardiography assess
movement and thickness of the ventricular wall over time
What might you see in a short axis, M-mode study in a case of heart failure?
ventricular dilation reduced thickness ventricular wall enlarged atria reduced systolic contraction reduced fractional shortening
In the event of dilated cardiomyopathy, what is the hearts problem
No issue with electrical conductivity, rather a functional problem with contractility
Define contractility
the force that can be generated at any given length
Why does cardiomegaly occur in dilated cardiomyopathy ?
chronic volume overload –> chamber dilation
Dilated cardiomyopathy affects heart valves how?
AV valves fail to co-apt –> regurgitation (which will further decrease EF)
Why does dilated cardiomyopathy leads to ventricular tachycardia?
purkinje fibres or cardiac myoctues are spontaneously depolarising due to stretch myocardium that has caused cardiomegaly
The functional change to the stretched cells means they become more permeable to Na
Coronary blood flow & APT will be diminished, hypoxia (cardiac myocutes are totally dependant on aerobic resp)
