Heart Failure Flashcards
What is Left Ventricular Failure?
Failure of the left ventricle to effectively pump blood to the body - resulting in a gradual increase in pressure in the left atrium and pulmonary vascular system
What is the effect of Left Ventricular Failure?
Results in pulmonary hypertension - which increases the filtration rate in the alveoli - creating pulmonary oedema
How does LVF occur?
Increased load on the heart
What conditions can cause left ventricular failure?
hypertension
aortic valve stenosis or aortic valve regurgitation
Impaired contractility of the myocardium following acute coronary syndrome
What is the pathophysiology of left ventricular failure?
Increased load on the heart causes LV myocardial hypertrophy
Hypertrophy = increased size and number of myocytes = increased demand for oxygen and increased distance for diffusion of oxygen
Workload can cause the ventricle to stretch and dilate
Overall increased force required to maintain CO - there is a reduced ejection fraction
what happens to EDV in LVF?
gradually increased as the stiffness and reduced contractility mean less blood is pumping away from the heart
What is ejection fraction?
Stroke volume (expressed as a percentage of the end diastolic volume)
What are the core symptoms of LVF?
Pulmonary oedema
Shortness of breath (particularly when lying flat)
Chronic cough
Fatigue - there is less blood supply to meet the bodies needs
Watery mucus
What are the risk factors for LVF?
Coronary Artery Disease
Hypertension
Obesity
Diabetes
What are the physiotherapy interventions in LVF and RVF?
May have reduced exercise capacity
Strengthen the heart - gentle aerobic exercises
What is right ventricular heart failure?
Aka Cor Pulmonlae - Failure of the right ventricle to effectively pump blood to the heart - resulting in a gradual increase in pressure in the veins
Why does right ventricular failure occur?
Secondary to cardiopulmonary disorders (e.g. COPD) - there is hypoxic vasoconstriction of the blood vessels in the lungs leading to pulmonary hypertension.
Can also occur secondary to pulmonary hypertension caused by LVF.
What is the effect of pulmonary hypertension on RVF?
When the pulmonary pressure is too high, the right side of the heart must pump harder to perfuse the narrowed vessels in the heart.
The increased work on the heart causes myocardial hypertrophy which increases the demand for O2.
Since the body cannot supply enough O2 to the tissues, there is RV ischemia and pumping power is further reduced - resulting in an increased pressure in the systemic veins
What are the symptoms of RVF?
Lower leg oedema
Weight gain
Loss of appetite
What is congestive cardiac failure?
when there is both LVF and RVF meaning there is congestion in both the pulmonary and systemic circulations
