Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year 2 > Heart Failure > Flashcards

Heart Failure Flashcards

(63 cards)

Start Studying
1
Q

Cause of Heart Failure

A
  1. Hypertension
  2. IHD
  3. Alcohol
  4. Cardiomyopathy
  5. Valvular
  6. Pericardial causes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How does HF effect Venous return

A
  1. Myocardial failure leads to reduction of blood ejected with each beat + increase in volume remaining after systole
  2. Increased diastolic volume stretches myocardial fibres (increased force of contraction) - compensation mechanism
  3. Myocardium eventually fails and can’t be compensated for
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How does HF effect Afterload

A

After load - resistance against which LV contracts (increase decreases CO)

As volume of blood ejected increases, after load increases which exacerbates problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does HF effect Myocardial contractility

A
  1. HF activates sympathetic NS via baroreceptors - maintains CO
  2. Chronic sympathetic activation causes myocyte apoptosis even if there is temporary increase in contractility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Acute Decompensated CHF vs AHF

A

Generally effects <70 vs 71-76

Male vs Female dominance

LVEF < 40% vs LVEF> 40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is LVSD commonly caused

A

IHD, VHD and hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is diastolic heart failure

A

Heart Failure where stiffness in Lv increases and compliance decreases - impaired LV diastolic filling so decreased CO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Symptoms of HF

A
  1. Dyspnoea
  2. Fatigue
  3. Tachycardia
  4. Cardiomegaly
  5. Pleural effusion
  6. Fourth heart sounds
  7. Ascites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is HF investigated in blood tests

A
  1. Full blood count, thyroid function, cardiac enzymes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is Hf diagnosed

A

Echocardiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does an electrocardiogram help with AF

A

Identifies Ischaemia, hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CXR in HF diagnosis

A

Looks for pulmonary congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What two systems are involved in the heart failure syndrome

A
  1. Sympathetic system
  2. RAAS
  3. Inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does the sympathetic system lead to HF

A
  1. Increased NE released from cardiac cells
  2. SHort-term increase of CO
  3. B-receptor transduction is altered
  4. Progressive myocardial dysfunction
  5. HF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does the RAAS system cause HF

A
  1. Increase in venous pressure occurs when ventricles fail cause retention of Na and water and accumulation in interstitium
  2. Reduced CO causes reduced renal perfusion
  3. RAAS activated
  4. RAAS causes more salt and water retention
  5. Increased ANP to antagonise salt retention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is RAAS system treated in patients with HF

A
  1. Given Neprilysin inhibitor (sacubitril) which stops angiotensin II -> AT-II (1) - NO VASOCONSTRICTION OR RETENTION
  2. Causes production of AT-II (2) which is vasodilatory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Non-specific symptoms of HF

A
  1. SOB
  2. Fatigue
  3. Ankle swelling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Specific signs of HF

A
  1. JVP
  2. S3
  3. Displaced apex beat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the NYHA classification

A

Class I: No Limitation (asymptomatic)
Class II: Slight Limitation (mild HF)
Class III: Marked Limitation (moderate HF)
Class IV: Inability to carry out any physical activity without discomfort (sever HF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Stages of HF

A

1, High risk

  1. Asymptomatic
  2. Symptomatic HF
  3. End-stage HF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Causes of acute decompensation of CHF

A
  1. NSAIDS
  2. treatment noncompliance
  3. Excess alcohol
  4. Obesity
  5. Uncorrected high BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Complications of ADCHF

A
  1. Renal dysfunction
  2. Rhythm disturbances
  3. Hepatic dysfunction
  4. DVT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why are diuretics (thiazides) given in AF

A

Promotes renal excretion of Na and water by blocking Na/Cl co-transporters (will cure oedema and dyspnoea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How does ACEI (angiotensin-converting enzyme inhibitors) help with AF

A

1, Reduce mortality

2. Less Effective in blacks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Name an aldosterone antagonist
Spironolactone
26
side-effects of aldosterone antagonists
Hyperkalaemia | Renal impairment
27
What beta-blocker should be given to AFs
Bisoprolol - increases heart function
28
When should ARBs (angiotensin receptor blockers) be given
If a patient is experiencing side-effects and intolerance to ACEI
29
What arterial and venous dilators should be given
Hydralazine and Nitrates as a combo
30
When is Hydrazine and nitrates given
Patient tolerant to ACEI
31
What do we do with HF that has preserved left ventricular ejection fraction
Diuretics to deal with congestion Aldosterone antagonists possibly (don't write in exams)
32
Consequence of Ankylosing spondylitis and AF
Surgery needs to done
33
What is Hibernating Myocardium
Reversible Left ventricular dysfunction that responds positively to inotropic stress Revascularisation could cause it to recover.
34
how is Hibernating Myocardium caused
Decreased myocardial perfusion allows viability of heart muscles to be maintained
35
Name four common surgeries involved with HF
1. Mitral valve repair 2. Aortic valve replacement 3. Mitral valve replacement 4. Lv re-modelling
36
When should re-synchronisation and defibrillators be used
1. Defibrillator reduces arythmie mortality | 2. Multi-site pacing
37
What is Left-sided heart failure
The left side of the heart is responsible for receiving oxygenated blood from lungs. Inability of LV to pump blood through aorta causes blood to move back into the lungs = congestion Increased pressure in pulmonary circuit = pulmonary oedema Decreased oxygenated blood travelling around the body = cyanosis, dyspnoea, difficulty breathing due to oedema causing pericardium to thicken, increased rate of breathing
38
Heart sounds in left-sided heart failure
1. Laterally displaced apex beat (due to enlarged heart) | 2. S3 gallop due to increased blood flow from atria to ventricles
39
What is right-sided heart failure
COR PULMONALE: Venous system dilates causing oedema in the lower legs Liver can't move blood through hepatic vein back to heart = liver enlargement Jugular venous pressure raised Nocturne Ascites
40
Why does right-sided heart failure cause nocturia
From fluid returning back to blood stream when lying down at night
41
Define acute decompensated heart failure
Sudden worsening of symptoms of heart failure
42
Signs and symptoms of decompensated heart failure
1. Difficullty breathing 2. Epsides of waking up from sleep gasping 3. Pulmonary oedema
43
What causes acute decompensated heart failure
MI Pneumonia AFs Recurrent infections basically
44
Clinical signs of acute decompensated heart failure
Jugular venous distention (most probable sign)
45
Systolic vs diastolic heart failure
Systolic: Reduced ejection fraction Diastolic: Preserved ejection fraction
46
What can causes systolic heart failure
Restrictive pericarditis
47
What can cause diastolic heart failure
Cardiac tamponade and pericarditis
48
Clinical presentation of an aortic dissection
1. Vomiting 2. Sweating 3. SEVERE CHEST OR BACK PAIN (tearing feeling) 4. MI 5. Pleural effusions
49
Risk factors for aortic dissection
1. High BP 2. Ehlers Danlos syndrome (effects connective tissue of blood vessels) 3. Bicuspid aortic valve
50
Pathophysiology of aortic dissection
1. Blood penetrates intimate and enters the media | 2. High pressure rips media tissue apart, forming a false lumen through which blood flows through
51
How is aortic dissection diagnosed
1. D-dimer test 2. Chest X-Ray to see widening mediastinum + Pleural effusions 3. CT angiography 4. MRI 5. Transoesophageal Echocardiogram
52
How is aortic dissection treated
1. Propranolol 2. Nitrates If propranolol is contraindicated, then verapamil or dilitiazem (calcium channel blockers) Open aortic surgery
53
Definition of hypertension
<140/90 mmHG
54
What is primary essential hypertension
Hypertension with no identifiable cause
55
What causes primary essential hypertension
1. Genetic factors | 2. Diet (increased Na, insulin resistance, endothelial dysfunction etc)
56
What is the classic symptoms of peripheral vascular disease
1. Leg pain when walking that resolves with rest - INTERMITTENT CLAUDICATION
57
Clinical presentation of peripheral vascular disease
1. Intermittent claudication (because during exercise, leg needs more oxygen and nutrients) 2. Critical limb ischaemia 3. Gangrene
58
What is critical limb ischaemia
1. Obstruction to blood flow is so bad that the leg can't be oxygenated at rest either
59
Clinical presentation of critical limb ischaemia
1. Pain at rest 2. Cold 3. Numbness 4. Gangrene and ulcers
60
Risk factors for PVD
1. Smoking 2. Diabetes Mellitus (high blood sugar) 3. Hyperlipidaemia 4. Hypertension 5. Black Men
61
Diagnosis of PVD
1. Decreased or absent pulses 2. Muscle wasting 3. Cyanosis 4. Coolness of the limb 5. Thickened nails 6. Hair loss on skin 7. Buerger's test for pallor
62
How is PVD treated
1. SMOKING CESSATION 2. REGULAR EXCERCISE Manage diabetes, hypertension and hyperlipidaemia e.g. simvastatin, warfarin, aspirin and clopidogrel Third line: REVASCULARISATION (angioplasty) Thrombolysis Atherectomy
63
Diagnosis of PVD
1. Ankle, Branchial Index (less than 0.9 is PVD) 2. Then lower limb doppler ultrasound 3. X-ray 4. CT 5. Magnetic Resonance Angiography

Year 2 (155 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions