Heart Failure I - Pathophysiology Flashcards

1
Q

T or F: HF is largely a disease of the Aged

A

True, median age is 75

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2
Q

General definition of HF

A

The inability of the heart pump to pump blood forward at a sufficient rate to meet the metabolic demand of the body (forward failure), or the ability to do so only if the cardiac filling pressures are abnormally high (backward failure)

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3
Q

Key requirement component of HF

A

Poor forward blood flow (decreased CO)

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4
Q

T or F: Backward buildup of pressure is almost always present as well

A

Ture, results in congestion (increased filling pressure)

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5
Q

What relationship states that the more the LV is filled, the more it will contract

A

Frank-Starling’s law

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6
Q

Increased Preload for the same inotropic states results in what?

A

Increased SV (this, increased CO)

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7
Q

What are the determinant agents of inotropy?

A
  • Catecholaminergic/adrenergic

- Calcium

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8
Q

T or F: Inotropy produces increased SV for the same level of preload

A

Ture

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9
Q

What are the major types of HF

A
  • Systolic and Diastolic

- Left sided vs. Right sided

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10
Q

What are the hallmarks of systolic HF?

A
  • Decreased ejection fraction (HFeEF, LVSD)
  • Ventricular enlargement (Dilated Cardiomyopathy)
  • A problem with the squeeze
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11
Q

What measures are decreased in systolic HF?

A

Loss of inotropy= low SV and lower generated systolic BP

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12
Q

List Primary causes of systolic HF

A
  • Direct destruction of heart muscle cells (MI)
  • Overstressed heart muscle
  • Volume overloaded heart muscle
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13
Q

What are the hallmarks of Diastolic HF?

A
  • Normal ejection fraction (HFpEF)
  • Ventricular wall thickening (LVH)
  • Impaired filling
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14
Q

What measures are different in diastolic HF?

A

lower SV

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15
Q

Primary causes of diastolic HF?

A
  • High afterload/pressure overload
  • Myocardial thickening/fibrosis
  • External compression
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16
Q

Normal systemic vs pulmonary bp

A
  • Systemic: 120/80 mmHg

- Pulmonary: 22/10 mmHg

17
Q

T or F: R ventricle does less work

A

True

18
Q

Consequences of R Sided HF

A
  • Decreased circulating blood flow (forward RV HF)

- increased venous pressures (Backwards RV HF)

19
Q

Primary causes of R sided HF

A
  • L HF
  • Lung disease/pulmonary HTN/RV pressure overload (car pulmonale when primary lung disease causes HF)
  • RV volume overload
  • Damage to the RV myocardium
20
Q

T or F: HF forms clinically coexist

A

True, systolic dysfunction is typically accompanied by diastolic dysfunction and vice verse

21
Q

What is the underlying problem with HF?

A

reduced CO

22
Q

List the compensatory responses to HF

A
  • neurohumoral activation
  • Frank-Starling (increased preload)
  • Ventricular hypertrophy and dilation
23
Q

What 2 regulation systems are activated by HF?

A
  • Adrenergic activation

- Renin-angiotensin system