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LSS: cardiovascular system > heart failure > Flashcards

heart failure Flashcards

1
Q

what is cardiac output ?

A

stroke volume x heart rate

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2
Q

what is inadequate in heart failure?

A

cardiac output

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3
Q

what is the stroke volume dependent on?

A

the preload - inadequate venous return afterload- excessive resistance inadequate contractility

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4
Q

what is stroke volume?

A

this is end diastolic volume - end systemic volume

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5
Q

what is ejection fraction?

A

stroke volume / end diastolic volume

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6
Q

how do we look at ejection fraction?

A

transthoracic echocardiogram

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7
Q

how to define heart failure

A

the inability of the heart to keep up with the demand results in -Inadequate perfusion of organs (e.g. brain, liver, kidneys) - Congestion in lungs and legs - Collection of signs and symptoms

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8
Q

what are the types of heart failure?

A

left vs right chronic vs acute HFrEF vs HFpEF

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9
Q

what happens in left heart failure?

A
  • dysfunction associated with the left ventricle - ejection or filling issue - blood backs up into the lungs causes congestion
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10
Q

what are symptoms of left heart failure?

A

Breathlessness, couging , wheezing ‘Respiratory symptoms’ Also dizziness and cyanosis

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11
Q

what happens in right heart failure?

A
  • dysfunction with the right ventricle - ejection or filling issue - due to block up in lungs the right ventricle has to contract against a higher force (after load) therefore often a consequence of left heart failure due to the pulmonary hypertension
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12
Q

describe chronic heart failure? symptoms?

A
  • slow onset - infection - pulmonary embolism - myocardial infarction - surgery
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13
Q

describe acute heart failure? symptoms ?

A

rapid onset similar to chronic - worsening is much more severe

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14
Q

describe heart failure with reduced ejection fraction ?

A
  • abnormal systolic function - impaired contraction of the ventricles which despite an increase in HR results in decreased CO - the weakness is caused by damage of the ventricular myocytes - weaker ejection means higher diastolic pressures
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15
Q

what happens to stroke volume and end diastolic volume? and EF?

A

stroke volume has decreased but EDV stays the same so lower EF

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16
Q

what happens to stroke volume and end diastolic volume? and EF? in preserved ejection fraction

A
  • SV has gone down - EDV has gone down - so the ejection fraction is preserved
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17
Q

describe preserved ejection fraction

A
  • heart failure but it has a preserved ejection fraction - there is abnormal diastolic function - there is normal contraction of the ventricle - there is increased stiffness of the ventricle - so it cannot relax or fill properly - both EDV and stroke volume are reduced so EF remains the same
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18
Q

what is epidemiology of heart failure?

A

cases rise over 60

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19
Q

what are the causes of heart disease?

A
  • valve disease -IHD - Myocardial infarction - hypertension dilated cardio-myopathy - hypertrophic cardiomyopathy
20
Q

how does valve disease cause heart failure?

A
  • hardening of valve reduces ventricular filling or ejection
21
Q

how does Ischemic HD cause heart failure?

A
  • narrowing of coronary arteries causes ischaemia in the heart muscle
22
Q

how does myocardial infarction cause heart failure?

A
  • significant occlusion leads to death of cardiac muscle
23
Q

how does hypertension cause heart failure?

A
  • hypertension increases after load which means ventricle must work harder
24
Q

how does dilated cardiomyopathy cause heart failure?

A

dilated LV reduces generatable pressures which reduces ejection

25
Q

how does hypertrophic cause heart failure?

A

Increased LV thickness reduces internal ventricular volume & impedes filling

26
Q

most common heart failure cause?

A

coronary heart disease

27
Q

what symptoms does the patient experience?

A
  • breathlessness - fluid accommodation - fatigue - orthopnoea - anorexia weight loss -Paroxysmal nocturnal dyspnoea
28
Q

what are the clinical features of heart failure?

A
  • tachycardia - reduced pulse volume - pitting oedema - increased JVP - hepatomegaly - ascites
29
Q

what is JVP?

A

raised jugular venous pressure - increased pressure in right side of the heart leads to pressure in the systemic veins especially the jugular vein

30
Q

what spitting oedema?

A

Fluid accumulation in tissue (especially of lower extremities) leads to a pitting effect when physically depressed. The indentation is visible for a short period

31
Q

what is ascites?

A

fluid accumulation in peritoneal cavity

32
Q

what is BNP?

A

B-type natriuretic peptide (BNP) marker of heart failure - released from ventricular myocytes in response to stress

33
Q

what does BNP cause?

A
  • vasodilation of micro vessels - reduced aldosterone secretion reduced sodium reabsorption - inhibits renin secretion which means reduced Extracellular fluid which means reduced pressure
34
Q

what is the treatment - lifestyle based?

A
  • weight loss - stop smoking - exercise - less alcohol
35
Q

what is the treatment medication based?

A
  • ACE inhibitor - beta blockers - diuretics (reduce excess fluid)
36
Q

what is the general treatment plan for heart failure?

A
  • ACE inhibitors - add beta blockers - add diuretics
37
Q

what do diuretics and ACH inhibitors do?

A

after load decreased

38
Q

what do beta blockers do?

A

Beta-blockers reduce the speed of heart, which saves energy and makes it easier

39
Q

what do ACE inhibitors do?

A

Angiotensin converting enzyme inhibitors (ACE inhibitors) are medications that slow (inhibit) the activity of the enzyme ACE, - which decreases the production of angiotensin II. - As a result, blood vessels enlarge or dilate, - blood pressure is reduced.

40
Q

***what is laplaces law?

A

insert pic

41
Q

what is the primary heart failure therapy?

A
  • reduce the left ventricle wall stress
42
Q

***** when damage happens what is the beneficial physiological response or pathophysiological response?

A

insert pic

43
Q

how do heart failure patients feel?

A
  • breathless and tired - heart is damaged and cannot pump - marked neurohormonal activation - quality of life is poor - life expectancy is reduced
44
Q

what is NYHA classification?

A

new york heart association classification class 1 2 3 4 based on patients physical limitations

45
Q

****what is a graph showing profession of heart failure?

A

insert pic

46
Q

how is diagnosis of heart failure done?

A
  • cardiac imaging exercise testing biomarker analysis
47
Q

***summary of topic

A

insert pic

LSS: cardiovascular system (17 decks)

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