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Cardiovascular Medicine > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

What is heart failure

A

When the output of the heart is incapable of meeting the demands of the tissues

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2
Q

What are the main types of heart failure

A

High output failure

Low output failure

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3
Q

Describe high output failure and give examples

A

Demands of the system have increased beyond the capacity of the pump
eg - anaemia, thyrotoxicosis

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4
Q

Describe low output failure and give examples

A

Pump is failing and not strong enough to force liquid around the body
eg - cardiac defects such as MI or valve disease

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5
Q

Which type of heart failure is most common

A

Low output failure

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6
Q

What other terms can be used to describe heart failure

A

Left heart failure
Right heart failure
Congestive heart failure - both sides

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7
Q

Describe systolic dysfunction

A

During diastole the enlarged ventricles fill with blood

During systole the ventricles pump out less than 40-50% of the blood

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8
Q

Describe diastolic dysfunction

A

During diastole the stiff ventricles fill with less blood than normal
During systole the ventricles pump out about 60% of the blood, but the amount may be lower than normal

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9
Q

Describe diastole and systole in a normal, healthy heart

A

During diastole, the ventricles fill normally with blood

During systole, the ventricles pump out about 60% of the blood

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10
Q

What causes systolic dysfunction

A

Muscle loss or stiffness of ventricle walls

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11
Q

What are common causes of low output failure

A 
Heart muscle disease
Pressure overload
Volume overload
Arrhythmias 
Drugs
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12
Q

Which drugs can cause low output heart failure

A

Beta blockers
Corticosteroids
Anti cancer drugs

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13
Q

What are the compensation mechanisms of heart failure and what effect does this have

A

Body increases circulating blood volume if blood is lost

Has a negative effect and makes heart failure worse

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14
Q

What are the signs of left heart failure

A

Dyspnoea
Tachycardia
Low blood pressure
Low blood volume and pulse

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15
Q

What are the signs of right heart failure

A 
Elevated venous pressure
Swollen ankles
Ascites
Raised JVP
Tender, enlarged liver
Poor GI absorption
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16
Q

What is the problem in left heart failure

A

Blood being pumped by right side towards left side isn’t pumped out of left side into circulation so lungs have a build up of blood so increased blood pressure

17
Q

What is the problem in right heart failure

A

Systemic veins will be filling as blood isn’t taken away and carried around the body and therefore the venous pressure will increase leading to fluid transudating from the veins into the body tissues

18
Q

What is ascites

A

Fluid within the abdominal cavity

19
Q

What are the symptoms of heart failure

A 
Shortness of breath
Swelling of feet and legs
Chronic lack of energy
Difficulty sleeping due to breathing problems
Swollen or tender abdomen with loss of appetite
Cough with frothy sputum
Increased urination at night
Confusion and/or impaired memory
20
Q

How can heart failure cause ankle swelling

A

Fluid accumulates in peripheral tissues from right sided failure

21
Q

What is pitting oedema and what does its position indicate

A

Fluid accumulation in superficial tissues that can be squeezed out of the way by pressure
Higher up the leg it appears, the more severe the heart failure is

22
Q

How is acute heart failure treated

A

Emergency hospital management

Oxygen, morphine and frusemide

23
Q

How does acute heart failure present

A

Left side has sudden loss of function
Fluid accumulates in the lungs
Patient is short of breath

24
Q

How is chronic heart failure treated

A

Community based
Improve myocardial function
Reduce compensation effects
Where possible treat the cause

25
Q

What are possible underlying causes of heart failure that can be treated

A 
Hypertension
Valve disease
Heart arrhythmias
Anaemia
Thyroid disease
26
Q

Which drugs work against heart failure and should be stopped

A

Negative inotropes - Beta blockers

27
Q

What drugs can be used to treat heart failure

A

Diuretics to increase salt and water loss
ACE inhibitors to reduce salt and water retention
Nitrates to reduce venous filling pressure
Inotropes such as digoxin

28
Q

What can be done when treating heart failure to improve cardiac function

A

Assist pumps which work with the heart to pump blood around the body
Heart transplant where it has been damaged and there is no prospect of improvement

Cardiovascular Medicine (11 decks)

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