Heart failure

Question 1

Compensations in chronic heart failure (4)

Answer 1

1) Increased renal salt and water retention = Increasing JVP and stroke volume
2) Baroreceptor reflex increases sympathetic tone - increases HR + contractility
3) Peripheral vasoconstriction - diversion to coronary and cerebral circulations
4) Ventricular hypertrophy + remodelling

Question 2

What is the pathogenesis of cardiogenic pulmonary oedema? (3)

Answer 2

• Left heart failure means increased left ventricular end diastolic pressure
• Increased pulmonary capillary hydrostatic pressure
• Fluid collects in extravascular pulmonary tissues faster than lymphatics clear it

Question 3

What are the two ways of categorising heart failure? (2)

Answer 3

1) Systolic vs diastolic

2) High CO output vs low CO output

Question 4

What is systolic heart failure?

Answer 4

Caused by decreased left ventricular ejection fraction - poorly contracting left ventricle

Question 5

What is diastolic heart failure?

Answer 5

Preserved left ventricle ejection

• Normal contractile function
• But LV stiff so filling impaired
• Due to chronic hypertension = LV hypertrophy