Heart Failure, Myocarditis, Cardiomyopathies, and Pulmonary HTN I Flashcards
CHF
SYNDROME NOT DISEASE
same syndrome can occur with different diseases
abnormality of cardiac structure or function responsible for inability of heart to eject or fill with blood at rate sufficient to meet demands of metabolizing tissues
congestive heart failure
HR and heart failure
too slow - decreased CO
too fast - not enough time to fill
impaired relaxation and compliance
diastolic dysfunction
normal heart function with increased metabolic demand or increased peripheral blood flow from decreased PVR
high output failure
pulmonary edema
increased LA pressure
JVP, hepatomegaly, intestinal edema
increased RA pressure
CO = ?
HR x SV
SV = ?
EDV - ESV
EF = ?
SV/EDV
failure to eject
forward failure
-decreased perfusion of organs/tissues down-stream from heart
congestion
backward failure
-backing up of blood into organs upstream
increasing hydrostatic pressure, leads to congestion/edema
forward failure Sx in left sided failure
systemic circulation
backward failure Sx in left sided failure
congestion in lungs
backward failure Sx in right sided failure
systemic venous circulation
-upstream
acute heart failure
forward failure**
flash pulmonary edema
massive MI, chorda rupture, large PE
chronic heart failure
slow, exacerbations
predominantly backward failure**
hypertrophic cardiomyopathy
diastolic left heart failure
dilated cardiomyopathy
systolic left heart failure
valvular regurg
increased preload
systolic left heart failure
valvular stenosis
increased afterload
systolic left heart failure
thyrotoxicosis
metabolic disorder
-high output heart failure
anemia, AV fistula, beriberi
excessive blood flow high output failure
aortic stenosis
hypertrophic cardiomyopathy
toxins
alcohol, cocaine, radiation
dilated cardiomyopathy
myocarditis
dialted cardiomyopathy
SLE, scleroderma, RA, polyarteritis nodosa, dermato-myositis
dilated cardiomyopathy
CAD/MI
dilated cardiomyopathy
HTN
dilated cardiomyopathy
HTN > LVH > diastolic dysfunction > ventricular dilation > systolic dysfunction
aortic regurg
dilated cardiomyopathy
increased EDV/preload >increased cardiac workload > LVH > LV dilation > systolic dysfunction
myocarditis
dilated cardiomyopathy
viral, bacterial, fungal, helminth
febrile illness or URI
can lead to myocarditis
doxorubicin
chemotherapy
can cause myocarditis
toxic myocarditis causes
chemo drugs heavy metals lithium malaria drugs radiation
autoimmune myocarditis
giant cell myocarditis
PM
alcoholic cardiomyopathy
prolonged exposure
-10 years
toxic effects on myocardium
pregnancy cardiomyopathy
dilated
takotsubo cardiomyopathy
dilated
- triggered by stress
- majority women
aka stress, broken heart syndrome, apical ballooning syndrome
myosin heavy chain mutation
hypertrophic cardiomyopathy
autosomal dominant
IV septum - often disproportionately involved
majority diastolic dysfunction
valsalva increases what murmur
hypertrophic cardiomyopathy
decreased venous return - walls closer together - louder murmur
restrictive cardiomyopathy
impaired filling
-diastolic dysfunction
amyloidosis, sarcoidosis, hemochromatosos, glycogen storage diseases, metabolic disorders, radiation, scleroderma, lofflers
restrictive cardiomyopathy
idiopathic pulmonary HTN
primary
females
age 30-50yo
autosomal dominant
survival - 2-3 yrs from Dx
left to right shunt
pulmonary HTN
drugs with pulmonary HTN
fenflumarine
-weight loss pill
amphetamines
cocaine
most common cause of pulmonary HTN
cor pulmonale
pulmonary Dx > pulmonary HTN > increase RV afterload > RV hypertrophy > RV failure
pulmonary embolism
from lower extremities
increased pulmonary artery pressure
increased aferload for right ventricle
right ventricular failure