Heart Failure Flashcards

1
Q

Definition

A

inability of heart to pump sufficient blood to meet needs of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most common hemodynamic disorder

A

Heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Prevalence

A

Rises sharply in old age (80 and older especially)

Most common in older women

AA prevalence is 25% higher than caucasians

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Most common STRUCTURAL correlate to Heart failure (Heart Failure is a Functional syndrome)

A

MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Risk factors

A
  1. CAD
  2. Smoking
  3. HTN
  4. Overweight
  5. Diabetes mellitus
  6. Valvular Heart Disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Acute HF or Chronic HF more common?

A

Chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Most frequent cause of Chronic HF

A

old MIs (usually multiple)…“ischemic cardiomyopathy”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Causes of acute HF

A
  • -CAD

- -acute MI or even acute myocardial ischmia that isn’t an infarction yet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cause of HF…impaired contractility

A

CAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cause of HF…excessive afterload (exceeding ability of heart to compensate)

A

Severe hypertension

Stenosis of the aortic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Causes of HF that lower ejection fraction

A

aortic stenosis
severe hypertension (Decompensated)
CAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Causes of HF that usually preserve the ejection fraction

A
**Compensated HTN
left ventricular hypertrophy
resstrictive cardiomyopathy
pericardial disease
Sometimes transient myocardial ischmia
--if impairs O2 and nutrient delivery needed for early diastolic relaxation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Typical signs of HF

A
  • -cardiomegaly (dilation of the chambers rather than thickening of the walls…exacerbates problem b/c increases stress)
  • -
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Most common symptom of HF

A

dyspnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When pulmonary venous pressure goes from 8 to 20mmHg…

A

transudate passes from veins to interstitium…

interstitial edema compresses bronchioles and alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

HF presentation

A
dyspnea
Paroxysmal nocturnal dyspnea (PND)
orthopnea (dyspnea w/ laying down)
fatigue
weakness
17
Q

Two most specific symptoms of HF

A

PND

orthopnea

18
Q

Two most common symptoms of HF

A

Dyspnea

Fatigue

19
Q

Signs of HF

A
tachycardia
tachypnea
Hypotension
pulmonary crackles
pulmonary wheezing
diaphoresis
gallops
Dulled mental status
oliguria
20
Q

Pulmonary crackles are associated w/…

A

pulmonary alveolar edema

21
Q

When pulmonary venous pressure goes over 25mmHg…

A

transudate passes into interstitium AND airspace, as the junctions b/w capillary endothelial and alveolar lining epithelial cells are pulled open by pressure

22
Q

crackles

A
  • -inspiratory sounds
  • -attributed to popping open of small airways occluded by edema b/w inspirations

–first heart at lung bases (where vascular hydrostatic pressure is highest)

23
Q

Cardiac asthma

A

wheezing due to edema around large airways

24
Q

Diaphoresis is sign of HF due to…

A

sympathetic nervous stimulation…a compensatory response

25
When is S3 heard?
early diastole
26
How does S3 sound?
dull, low-pitched "Kentucky"
27
What causes S3?
rapid filling
28
Is S3 always pathologic?
no...can be normal in children and young adults
29
Diagnosis of HF
Hx Physical CXR echocardiography
30
CXR findings
cardiomegaly pulmonary vascular congestion interstitial or alveolar edema
31
echocardiography
can be diagnostic | estimate of ejection fraction
32
What correlates w/ severity of HF?
EF | levels of BNP
33
compensatory mechanisms for heart failure?
increased BNP secretion
34
How do we differentiate dyspnea/pulmonary edema due to lung disease from HF?
- -elevated BNP levels=HF | - -
35
serum B-type natriuretic peptide
biomarker of HF