Heart failure and hypertension Flashcards
cardiology - day 3
Define heart failure
Clinical syndrome characterised by typical symptoms, accompanied by structural / functional cardiac abnormality, resulting in reduced cardiac output / elevated intracardiac pressures at rest or during stress.
Inability to pump blood around the body effectively.
What are the symptoms of HF ?
Breathlessness, fatigue, cough, palpitations, abdominal distension, loss of appetite, confusion
What are clinical signs on HF ?
tachycardia, weight gain/loss, pitting oedema, elevated jugular venous pressure, tachypnoea, inspiratory crackles
What are the common causes of HF ?
coronary heart disease, hypertension, cardiomyopathies, persistent arrhythmia, valvular heart disease, CHD, chronic lung disease, alcohol abuse
What are HF mechanisms ?
Decreased pump efficiency - myocytes destroyed and replaced by scar tissue eg myocardial infarction.
Decreased filling volume - ventricular walls less distensible due to hypertrophy
What does an ECG measure ?
Ejection fraction, assess filling pattern, look for causative mechanism
Describe the consequences for HF mechanisms ?
Loss of myocytes - contractility volume falls (stroke volume falls) / loss of distensibility - reduced preload (stroke volume falls)
Fall in cardiac output - inadequate organ perfusion - sympathetic nervous system and renin angiotensin aldosterone system activated - fluid overload - increased cardiac work and worsening HF
What are the treatments for HF ?
Beta blocker, ACE inhibitor, aldosterone antagonist, loop diuretic, self care, lifestyle advice
What is the short term regulation of hypertension ?
Sympathetic control - increased HR and contractility, vasoconstriction
What is the long term regulation of hypertension ?
Change in blood volume, regulated by the kidneys, RAAS
What is essential hypertension and what are some of the causes of it ?
No known cause.
Increased sodium and water retention (kidneys). Increased SVR (hardening of arteriole wall (age related). Increased sympathetic activity. Increased levels of angiotensin II
What is secondary hypertension and what are some of the causes ?
Definable cause. Endocrine disease, kidney disease, tumours, side effect of medication
