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Cardiovascular System > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

What is heart failure?

A

Inability of the heart to meet the demands of the body

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2
Q

What can cause heart failure?

A

IHD
Hypertension
Aortic stenosis
Arrhythmias

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3
Q

How does IHD cause heart failure?

A

Myocardial dysfunction due to scarring and remodelling

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4
Q

How does hypertension cause heart failure?

A

Increased afterload on ventricles

Accelerates atherscelerosis

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5
Q

How does aortic stenosis cause heart failure?

A

Increased afterload on ventricles

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6
Q

What can influence stroke volume?

A

Pre-load
Myocardial contractility
After-load

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7
Q

What is pre-load

A

The stretch on the ventricle just before contraction

- volume in ventricle at end of diastole

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8
Q

What is after-load?

A

Force heart has to contract against

- total peripheral resistance

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9
Q

What is Frank-Starling’s law?

A

More ventricular distension during diastole = greater volume ejected during systole

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10
Q

Why is CO reduced in heart failure?

A

Reduced pre-load
- impaired filling

Reduced myocardial contractility
- heart muscle no longer able to produce same force of contraction

Increased after-load

  • increased pressure ventricle contracting against
  • aortic stenosis or hypertension
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11
Q

What are the 2 main reasons a heart can fail?

A

Filling problem
- diastolic

Ejection problem
- systolic

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12
Q

How is heart failure classified?

A

Heart failure with reduced ejection fraction
- systolic dysfunction

Heart failure with preserved ejection fraction
- diastolic dysfunction

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13
Q

How is ejection fraction calculated?

A

Amount of blood pumped out of ventricle / total amount of blood in ventricle

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14
Q

What is normal ejection fraction?

A

> /= 50%

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15
Q

What is reduced ejection fraction?

A

<40%

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16
Q

What is the effect of reduced CO?

A

Reduces BP

  • baroreceptors = increased sympathetic drive
  • activation of RAAS
17
Q

What are the general symptoms of heart failure?

A

Fatigue
Breathlessness
Leg swelling

18
Q

Why is there oedema in heart failure?

A

Heart failure = increased pressure in venous circulation
Higher hydrostatic pressure at venule end of capillary bed
Lower gradient between hydrostatic and oncotic pressure
Less favourable for fluid returning to capillary

19
Q

What are the symptoms of left sided heart failure?

A 
Fatigue
Breathlessness
Orthopnoea
Paroxymal nocturnal dyspnoea
Basal pulmonary crackles
Cardiomegaly - displaced apex beat
20
Q

What are the symptoms of right sided heart failure?

A

Fatigue
Breathlessness
Peripheral oedema
Raised JVP

21
Q

What is the NYHA classification of heart failure?

A

New York heart association

Class 1
- no symptomatic limitation of physical activity

Class 2

  • slight limitation of physical activty
  • no symptoms at rest

Class 3

  • marked limitation of physical activity
  • no symptoms at rest

Class 4

  • inability to carry out any physical activity without symptoms
  • symptoms at rest
22
Q

What are the blood tests for heart failure?

A 
FBC
U+Es
Glucose / HbA1c
Lipid profile 
BNP
23
Q

What is BNP?

A

Brain natriuretic peptide

Marker of cardiac stress

24
Q

What may an ECG show?

A

Axis deviation - cardimegaly

Arrhythmias

25
Q

What does a chest x-ray show in heart failure?

A 
Bat wing signs 
Kerley B lines
Cardiomegaly 
Dilated upper lobe vessels
Pleural effusion
26
Q

What does an echo show in heart failure?

A

Changes in ejection fraction
Hypertrophy
Cardiomegaly
Valvular problems

27
Q

What is the management of acute heart failure?

A

Oxygen
IV furosemide
Heparin
Nitrates

28
Q

What is the effect of furosemide?

A

Immediate venodilation

Cardiovascular System (16 decks)

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