Heart Failure Case ILOs Flashcards
What are the main phases of the cardiac cycle?
The cardiac cycle consists of diastole (ventricular filling), systole (ventricular contraction), and isovolumetric phases (no volume change).
How do pressure changes in the heart relate to valve opening and closing?
When ventricular pressure exceeds atrial pressure, AV valves close; when ventricular pressure exceeds arterial pressure, semilunar valves open.
What effect does the sympathetic nervous system have on the heart?
The sympathetic nervous system increases heart rate (chronotropy), contractility (inotropy), and conduction speed (dromotropy).
What effect does the parasympathetic nervous system have on the heart?
The parasympathetic nervous system (via the vagus nerve) slows the heart rate and reduces the force of contraction.
What are natriuretic peptides, and what is their role in circulation?
Natriuretic peptides (e.g., ANP, BNP) promote vasodilation, reduce blood volume, and decrease blood pressure by increasing sodium excretion.
How does intracellular fluid differ from extracellular fluid?
Intracellular fluid is rich in potassium and proteins, while extracellular fluid contains more sodium and chloride ions.
How does oedema form?
Oedema forms when fluid accumulates in the interstitial space due to increased hydrostatic pressure, reduced oncotic pressure, or impaired lymphatic drainage.
What drives fluid movement between compartments?
Osmotic pressure and hydrostatic pressure drive fluid between compartments, with water moving towards areas of higher solute concentration.
What anatomical changes occur in heart failure?
Heart failure leads to ventricular hypertrophy, dilation, or remodeling, depending on the type and cause of the heart failure.
What is the pathophysiology of heart failure?
Heart failure occurs when the heart cannot pump efficiently, leading to reduced cardiac output, fluid retention, and increased pressure in the heart and lungs.
What causes heart murmurs anatomically?
Heart murmurs result from turbulent blood flow due to valve abnormalities like stenosis or regurgitation, or structural defects like septal defects.
What are the common signs and symptoms of heart failure?
Symptoms include shortness of breath, fatigue, ankle swelling, and signs like jugular venous distension and pulmonary crackles.
What are common causes of heart failure in the UK?
Common causes include coronary artery disease, hypertension, valvular disease, and cardiomyopathies.
What are key investigations for diagnosing heart failure?
Investigations include chest X-ray, ECG, BNP levels, and echocardiography to assess cardiac function and structure.
What is the role of echocardiography in heart failure diagnosis?
Echocardiography assesses heart size, function, ejection fraction, and valve function, helping to confirm heart failure and its cause.
What are the main principles of heart failure management?
Management includes lifestyle modification, medications (ACE inhibitors, beta-blockers, diuretics), and, in severe cases, devices or surgery.
How do ACE inhibitors help in heart failure?
ACE inhibitors reduce afterload and preload by blocking the formation of angiotensin II, lowering blood pressure and preventing fluid retention.
What are common side effects of ACE inhibitors?
Side effects include cough, hyperkalemia, hypotension, and renal impairment.
How do beta-blockers treat heart failure?
Beta-blockers reduce heart rate and myocardial oxygen demand, improve ventricular filling, and slow disease progression in heart failure.
How do SGLT2 inhibitors benefit heart failure patients?
SGLT2 inhibitors (e.g., dapagliflozin) reduce glucose and sodium reabsorption in the kidneys, leading to lower blood volume and reduced heart workload.
What are aldosterone antagonists and how do they work in heart failure?
Aldosterone antagonists (e.g., spironolactone) reduce fluid retention by blocking aldosterone, which promotes sodium excretion and potassium retention.
What is the role of loop diuretics in heart failure?
Loop diuretics (e.g., furosemide) reduce fluid overload by increasing urine output, relieving symptoms like pulmonary and peripheral oedema.
What are side effects of loop diuretics?
Side effects include hypokalemia, dehydration, hypotension, and electrolyte imbalances.
Describe the normal development of the heart in utero.
he heart forms from a single tube that folds and partitions into four chambers, with the septa and valves developing during weeks 4-7 of gestation.
What congenital heart defects can arise from abnormal heart development?
Defects include atrial septal defects (ASD), ventricular septal defects (VSD), tetralogy of Fallot, and transposition of the great arteries.
How do health inequalities impact cardiovascular disease risk?
Health inequalities, including poor access to healthcare, unhealthy lifestyle choices, and socioeconomic factors, contribute to higher rates of cardiovascular disease in disadvantaged populations.
What is the societal impact of heart failure?
Heart failure imposes a significant societal burden through healthcare costs, lost productivity, and the need for long-term care and support.
What are the differences in responses to acute illness vs. long-term conditions?
Acute illness often requires immediate, short-term interventions, while long-term conditions require chronic management, lifestyle changes, and ongoing support.
What is the Frank-Starling law in relation to heart function?
The Frank-Starling law states that the stroke volume of the heart increases in response to increased venous return, up to a certain point, by stretching the ventricular walls.
How do preload and afterload affect heart failure?
In heart failure, increased preload (due to fluid retention) and increased afterload (due to high blood pressure) worsen cardiac function by increasing the workload on the heart.
