Heart Failure Basics Flashcards
What is heart failure?
Heart can’t meet demand - insufficient to adequate perfusion
What can heart failure lead to?
Congestion / fluid build up
What can heart failure be split into?
Chronic = developing over time
Acute = sudden onset
Compensated = symptoms are stable
Decompensated = deterioration
What are the two types of HF?
Systolic
Diastolic
What is systolic heart failure?
Heart cannot pump efficiently
Decrease cardiac contractility - lower stroke volume
Ejection fraction affected
What is diastolic HF?
Ventricles reduced compliance
Reduced end diastolic volume
Reduced stroke volume
Not enough filling - reduction in pre-load
Both systolic and diastolic HF cause a decrease in cardiac output, what is the effect of this?
Arterial baroreceptor reflex triggered but discharge is less rapid then normal
Brain interprets the trigger as a larger decrease in pressure than normal
Heart rate increases as increase SNS and decrease PNS
Total peripheral resistance increase by increased sympathetic activation of systemic arterioles
Increase angiotensin II and vasopressin
What is the the increase in resistance and SNS have an effect on due to the low cardiac output?
Reduced renal blood flow
Low renin secretion
Increased plasma angiontenin and aldosterone
Increase Na + H2O retention
Increase blood volume
Increase central venous pressure (pre-load)
What are some causes of HF?
Ischaemic heart disease
Valvular heart disease
Hypertension
Arrhythmias
Cardiomyopathy
Congenital
Systemic Sensors
What are some risk factors for HF?
Hypertension - increased work load
Diabetes - strain / links to other conditions
CAD - reduced blood flow due to blockage
Obesity - linked to other conditions
Smoking - damage to blood vessels
Sedentary lifestyle - linked to other conditions
Alcohol - weakens heart muscle
Poor diet
Age - reduced elasticity, increased resistance - heart less efficient
Gender - men prior menopause, women after menopause
Ethnicity - BAME more likely to get hypertension
Previous MI - damage to heart wall - heart’s ability weakened
Ischaemia
Valvular heart disease - blood flow abrupt and force affected
Arrhthymias
What is paroxysmal nocturnal dysponea?
Fluid build up settles along large surface area in lungs when asleep
Causes breathlessness
During sleep respiratory centre in brain less responsive - respiratory rate and effort do not increase in response to reduced oxygen saturation compared to when awake
Allows person to develop pulmonary congestion and hypoxia before they wake uo
Less adrenaline circulation in sleep - myocardium more relaxed - decreased cardiac output
Symptoms improve over several minutes
What are symptoms of HF?
SOB
Dyspnea
Orthopnea - SOB when supine - build up of fluid covers a larger SA in lungs making it difficult to breathe
Fatigue / weakness - reduced cardiac output
Oedema - build up of fluid
Rapid / irregular HR
Persistent cough / wheezing - build up of fluid in lungs
White / pink mucus
Paroxysmal nocturnal dysponea
What signs do you get on examination?
Tachycardia
Tachpnoea
Hypertension
Murmurs
3rd ausculation sound
Bilateral basal crackles
Enlarged JVP
Peripheral oedema of ankles, legs and sacrum
What are symptoms of right sided HF?
Fatigue
Increased peripheral venous pressure
Ascites - excess fluid in interstitial spaces of liver and spleen can moved out into peritoneal cavity
Enlarged liver and spleen
Secondary to chronic pulmonary problems
Enlarged JVP
Anorexia
Weight gain
Dependent oedema
What are symptoms of left sided HF
Paroxysmal nocturnal dysponea
Elevated pulmonary capillary wedge pressure
Pulmonary congestion
Restlessness
Confusion
Orthoptera
Tachycardia
Exertion dyspnea
Cyanosis
Fatigue
