Heart failure as a drug target Flashcards

1
Q

Define heart failure.

A

The inability of the heart to pump blood effectively around the body.

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2
Q

What are the possible causes of heart failure?

A
Ischaemic heart disease 
Hypertension 
Valve disease 
Cardiomyopathy 
Arrythmias
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3
Q

What are the symptoms of heart failure?

A

Shortness of breath
Fatigue and weakness
Swelling (oedema)

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4
Q

Explain systolic heart failure.

A

The left ventricle is unable to contract completely and pump enough blood forcefully throughout the body. There is a reduced Ejection fraction

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5
Q

What is Left sided heart failure?

A

It occurs when the left ventricle doesn’t pump efficiently preventing the body from getting enough oxygen.
This causes fluid build up in the lungs and causes pulmonary oedema.

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6
Q

What is Right sided heart failure?

A

Not enough blood being pumped into the lungs

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7
Q

What is congestive cardiac failure?

A

Failure of both sides of the heart.

Fluid build up around the heart

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8
Q

What are the signs and symptoms of Right sided heart failure?

A
Swelling (oedema) especially in the lower limbs 
Heavy painful legs 
Difficulty walking 
Skin infections 
Tiredness, light headed and fainting
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9
Q

What process is not functioning properly in Left-sided heart failure?

A

Systolic (pumping dysfunction)

Due to damage of the myocardium, unable to contract as forcefully and pump as efficiently

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10
Q

What is the most common cause of Left-sided heart failure?

A

Ischaemic heart disease - coronary artery atherosclerosis

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11
Q

What is the most common cause of Left-sided heart failure? (Explain)

A

Ischaemic heart disease - coronary artery atherosclerosis

less blood and O2 gets through the coronary artery to the heart tissue due to plaque buildup, causing damage to the myocardium

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12
Q

What happens if the coronary artery becomes completely blocked?

A

Can cause a heart attack and leave scar tissue of the myocardium resulting in its inability to contract at all

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13
Q

What is pitting oedema?

A

When a swollen part of the body has a dimple ‘pit’ after you press it for a few seconds.

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14
Q

How many stages are there of congestive heart failure?

A

4

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15
Q

State the two ways of measuring heart failure?

A

BNP

Echocardiogram

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16
Q

What is BNP?

A

Brain naturietic peptide

it is secreted by the cardiomyocytes in the ventricles as a response to stretch

17
Q

What does a high BNP level indicate?

A

The severity of heart failure

correlated to the blood in ventricles

18
Q

How can an Echocardiogram indicate heart failure?

A

Dilated left ventricle with a reduced ejection fraction

19
Q

What is mitral regurgitation?

A

Leakage of blood backward through the mitral valve each time the left ventricle contracts

20
Q

What is cardiomyopathy?

A

Disease of the heart muscle.

21
Q

What is cardiac hypertrophy?

A

Abnormal enlargement, thickening of the heart muscle.

Filling of blood in the heart doesn’t occur properly.

22
Q

What is preload?

A

The amount of stretch on cardiac muscles after diastole.

at the end of ventricular filling

23
Q

What is the preload like during heart failure?

A

Elevated due to ventricular dilatation and increased blood volume

24
Q

What drugs can be used to reduce preload?

A

Loop diuretics = furosemide

Aldosterone antagonists = Spironolactone

25
Q

How do loop diuretics reduce preload?

A

Act on Na, K, 2Cl symporter in thick ascending limb of the loop of Henle.

26
Q

How can aldosterone reduce preload?

A

It decreased sodium reabsorption in the vital loop and collecting duct

27
Q

What is afterload?

A

The amount of pressure the heart has to contract to eject the blood during systole.

28
Q

How can afterload be reduced?

A

antihypertensives
ACE inhibitors = ramipril
Calcium Channel blockers = Amlodipine

29
Q

What is rate control?

A

Slowing down the heart to improve EF

30
Q

What drugs can reduce the heart rate?

A

Beta blockers

Calcium channel blockers

31
Q

What is rhythm control?

A

Improving heart efficiency can improve symptoms

32
Q

What drugs can improve heart rhythm?

A
Beta blocker (1st line)
Digoxin (add on)