Heart failure Flashcards
What is HF
Inability of cardiac output to meet the physiological demands of the body
Different classifications of HF
Left ventricular failure
Right ventricular failure
Low output and high output heart failure
Symptoms of Left ventricular failure
Paroxysmal nocturnal dyspnoea
Wheeze
Nocturnal cough with pink sputum due to pulmonary oedema
What causes the pink sputum in Left Ventricular Failure
Pulmonary oedema
Symptoms of Right ventricular failure
Usually caused by LVF or: Lung disease Peripheral oedema Ascites Raised JVP (Kussmaul sign)
Cause of low output and high output heart failure
Excessive afterload, excessive preload or pump failure
Causes of HF
Anything that causes myocardial damage may lead to heart failure: Coronary artery disease Hypertension Atrial fibrillation Valve disease Cardiomyopathies Infective endocarditis Anaemia Endocrine disorders Cor pulmonale
What is cor pulmonale
Right ventricular failure secondary to pulmonary disease
Causes of left-sided HF
Coronary artery disease Hypertension Aortic valve disease Mitral valve disease Myocardial disease
Causes of right-sided HF
Left-sided HF
Tricuspid valve disease
Pulmonary valve disease
Pulmonary vascular disease
Pathophysiology of congestive HF (CHF)
Left or Right-sided heart failure leads to Ischaemic Injury and thus reduced myocardial efficiency:
-Increased workload of heart muscles
-Decreased cardiac output
-Decreased contractility
Activates compensatory mechanisms
Chronic activation of these compensatory mechanisms worsens HF and leads to increased cardiac damage
Decrease compensatory mechanisms after ischaemic injury leads to increased workload and decreased CO and contractility
- Activation of Renin Angiotensin Aldosterone system (RAAS) causes Na+ ion and H2O retention and peripheral vasoconstriction. This increases preload
- Activation of the sympathetic NS increases heart rate and causes peripheral vasoconstriction. This increases afterload.
- Increased myocyte size
What can result from chronic activation of these compensatory mechanisms to HF
Worsens HF ad leads to increased cardiac damage
What causes cardiac dilation
Increased End-Diastolic volume
What is raised Jugular venous pressure (JVP) related to?
Right-sided heart failure
Fluid overload
