Heart Failure

Question 1

syndrome in which heart is unable to meet metabolic needs of tissues despite adequate venous return

Answer 1

heart failure

Question 2

severe ventricular dysfunction resulting in poor tissue perfusion and arterial hypotension

Answer 2

low output heart failure (“forward” HF, “cold”)

Question 3

cardiac malfunction resulting in marked increased pulmonary venous and/or systemic venous pressures

Answer 3

congestive heart failure (“backward” HF, “wet”)

Question 4

CO =

Answer 4

SV x HR

Question 5

SV =

Answer 5

EDV-ESV

Question 6

SV is regulated by what three things?

Answer 6

preload, afterload, contractility

Question 7

Frank-Starling law explains what?

Answer 7

preload increases > SV increases (force of contraction)

Question 8

afterload is largely determined by what?

Answer 8

degree of arterial and arterial constriction or dilation

Question 9

when afterload increases, SV does what?

Answer 9

decreases (force of contraction decreases)

Question 10

when contractility increases, SV does what?

Answer 10

increases

Question 11

T/F: RAAS activation is a chronic response to decreased CO

Answer 11

TRUE (hrs-days)

Question 12

what converts ang I to ang II?

Answer 12

ACE (from lungs)

Question 13

increased vasopressin and endothelin I, free radicals, and increased thirst are all stimulated by what in the RAAS system?

Answer 13

angiotensin II

Question 14

T/F: angiotensin II increases vasodilation and increases PSNS tone

Answer 14

FALSE, increases vasoCONSTRICTION and increases SNS tone

Question 15

what is the effect of aldosterone on sodium ?

Answer 15

increased reabsorption > increased water reabsorption > increases blood volume (SV)

Question 16

T/F: angiotensin II has negative effects chronically

Answer 16

TRUE, vasoconstriction > increased afterload > decreased CO as well as increased free radicals (causing cell death and fibrosis)

Question 17

pressure overload leads to what type of hypertrophy?

Answer 17

concentric

Question 18

volume overload leads to what type of hypertrophy?

Answer 18

eccentric

Question 19

T/F: CHF occurs when the volume of fluid entering the pericardial space overwhelms the lymphatics

Answer 19

FALSE, interstitial space

Question 20

T/F: CHF usually precedes low output HF

Answer 20

TRUE (body prioritizes maintenance of normal arterial pressure)

Question 21

what is the primary cause of valvular disease hypertension?

Answer 21

volume overload (increased preload) and pressure overload (increased afterload)

Question 22

what is the primary cause of myocardial disease?

Answer 22

myocardial systolic and diastolic dysfunction

Question 23

effusion in body cavities is a result of increased atrial pressure from what side of the heart?

Answer 23

RIGHT

Question 24

T/F: dogs and cats are susceptible to pleural effusion when they have L-CHF

Answer 24

FALSE, cats only

Question 25

T/F: L-CHF can result in pulmonary edema and pleural effusion in cats and dogs

Answer 25

FALSE, cats only

Question 26

what organ is most commonly affected by peritoneal effusion due to R-CHF?

Answer 26

liver!! often see hepatomegaly