Heart Failure I - patho Flashcards
Heart failure involves ____ failure and _____ failure
forward failure (low flow)
and backward failure (congestion)
- typically in response to low flow
forward failure
Heart failure is the inability of the heart to pump blood forward at a sufficient rate to meet the metabolic demands of the body
backward failure
ability to do so only if the cardiac filling pressures are abnormally high
what controls CO?
What controls SV?
HR x SV
SV controlled by:
Inotropy of the ventricles (+)
Preload of the ventricles (+)
Afterload of the ventricles (-)
Sum up Frank-starlin curve in 1 sentence
If you stretch the heart out more in diastole, it will contract more in systole.
Determinants of Inotropy
Catecholaminergic/adrenergic stimulation
Calcium
Describe the following axis for PV loops:
x-axis
y-axis
unlabled axis
x: volume inside the ventricles
y: pressure inside the ventricles
unlabeled axis: time
Major divisions of HF
systolic HF
Diastolic HF
Left-sided
Right-sided
- note: systolic is usually accompanied by diastolic dysfunction and vice versa
- and LV failure often causes RV failure
Types of ventricular remodeling and what type of HF does it typically result in?
Hypertrophied heart
- diastolic HF
Dilated heart
- systolic HF
A weak/damaged myocardium = what type of HF?
Systolic failure due to loss of contractility
Systolic dysfunction
what is it a problem in?
what is the hallmark?
A problem with squeeze
- ↓contraction / ↓ inotropy
Hallmark is:
1. Decreased ejection fraction
“HF with reduced ejection fraction” = HFrEF
“left ventricular systolic dysfunction” = LVSD
- Ventricular enlargement
“dilated cardiomyopathy” = DCM
- note: these are all the same terms. multiple names
3 primary causes of systolic heart failure
- direct destruction of heart muscle cells
- overstressed heart muscle
- volume overloaded heart muscle
Diastolic dysfunction
what is it a problem in?
what is the hallmark?
Impaired filling
- ↓lusitropy / decrease in relaxation
Hallmark is 1. Normal ejection fraction “HF with preserved ejection fraction” = HFpEF “preserved systolic function” = PSF 2. Ventricular wall thickening “left ventricular hypertrophy” = LVH
Right-sided heart failure
- what is it
- what does it cause
Stresses to the RV can cause it to fail to adequately pump blood through the lungs, which causes
↓ circulating blood flow (forward RV HF)
↑ venous pressures (backward RV HF)
HFrEF
HFpEF
Heart failure with reduced ejection fraction
- systolic HF
heart failure with preserved ejection fraction
- diastolic HF