Heart Failure Flashcards
1
Q
Define heart failure
A
- inability of the heart
- to generate sufficient CO
- to meet demands of body
- without increased filling pressure
- secondary to an underlying cause
2
Q
Most common cause of HF
A
coronary artery disease
hypertension
3
Q
Age group common HF
A
Over 70
4
Q
Presentation of chronic HF
A
- breathlessness with impaired exercise tolerance
- slowly progressive
- periods of acute decompensation
- state of fluid retention and overload
5
Q
Acute HF Presentation
A
- flash pulmonary oedema
- precipitating ischaemia, arrhythmia, intercurrent infection
- OR gradual deterioration = fluid accumulates, exercise tolerance falls, orthopnoea, PND
6
Q
Systolic HF alternative name
A
HFrEF
HF with mildly rEF
7
Q
Severities of systolic HF
A
- mild = 46-55% EF by Echo
- moderate = 36-45%
- severe = <35%
8
Q
Diastolic HF alternative name
A
HFpEF
- stiffness of ventricular wall with impaired filling and reduced CO
9
Q
Echo signs of diastolic HF
A
- LVH
- L atrial dilatation
- abnormal relaxation
10
Q
Right HF features
A
- fluid overload
- secondary to L. heart disease, cor pulmonale, congenital heart disease, cardiomyopathy
11
Q
Left HF Features
A
HFrEF
12
Q
Low output HF
A
- common
13
Q
High Output HF
A
- overworked heart
- physiological or pathophysiological
14
Q
What does HF result in?
A
- decreased SV and CO
15
Q
What is the neurohormonal response to HF?
A
- sympathetic system activated
- RAAS system activated
- both result in vasoconstriction and sodium and fluid retention
- further stress of ventricular wall and dilatation (remodelling)
- worsening ventricular function
- further HF
16
Q
Explain the RAAS mechanism?
A
- liver, vessels and brain produce angiotensinogen
- renin produced by JGA in kidney when blood flow to kidney is low
- renin converts angiotensinogen to angiotensin I
- ACE from lungs converts angiotensin I to II
- angiotensin II = vasoconstriction and enhanced sympathetic activity as well as aldosterone release
- aldosterone = salt and water retention
