Heart Failure PP Flashcards
1 cause of heart failure…
Systemic HTN
Causes of HF
Systemic HTN
MI
Valve disease
Diabetes
Others
Dysrhythmias
Obesity, Lung Disease, Sleep disorder (breathing)
CKD
Anemia, Hyperthyroidism, Infection, Drugs
The Frank-Starling Mechanism
Heart adjusts its force of contraction based on the amount of blood filling the ventricles (preload).
Maybe impaired by these problems (2)
Dilated cardiomyopathy or severe heart failure, where excessive stretch weakens the heart’s ability to pump effectively.
Increased preload & Cardiac output Leads to increased HR & BP / Increased Cardiac workload
Leads to…
LV dysfunction
Management of HF
MEDS
ACE inhibitors
ARBs
beta-blockers
aldosterone antagonists
interventions like device therapy or surgery, aim to slow or reverse these changes.
Description: Enlargement of the ventricular chambers due to increased volume or pressure.
Causes: Chronic volume overload (e.g., valve regurgitation) or heart failure.
Effects:
Initially helps maintain cardiac output.
Over time, leads to reduced contractility and heart failure.
Ventricular Dilation
Description: Thickening of the heart muscle (myocardium) in response to increased workload.
Types:
Concentric Hypertrophy: Due to pressure overload (e.g., hypertension).
Eccentric Hypertrophy: Due to volume overload (e.g., valve regurgitation).
Effects:
Can initially improve heart function.
May lead to stiff ventricles, diastolic dysfunction, and increased oxygen demand
Muscular Hypertrophy
Signs of HF (4)
Ventricular dilation
Muscle Hypertrophy
Apoptosis
Fibrosis
Ischemic heart disease (e.g., myocardial infarction).
Chronic hypertension leading to left ventricular hypertrophy.
Dilated cardiomyopathy.
Valvular diseases (e.g., aortic stenosis).
Arrhythmias.
Causes Low output or High output HF
Low output
Ischemic heart disease (e.g., myocardial infarction).
Chronic hypertension leading to left ventricular hypertrophy.
Dilated cardiomyopathy.
Valvular diseases (e.g., aortic stenosis).
Arrhythmias.
Leads to Low or High Output HF
Low output HF
Symptoms
Fatigue, weakness.
Cool extremities (due to poor perfusion).
Pulmonary congestion (e.g., dyspnea, orthopnea).
Peripheral edema.
Low or High Output HF
Low output HF
Causes:
Severe anemia.
Thyrotoxicosis (hyperthyroidism).
Arteriovenous fistulas or malformations.
Paget’s disease of bone.
Beriberi (thiamine deficiency).
Sepsis (due to profound vasodilation).
Low or high output HF
High
The heart pumps an abnormally high volume of blood, but it still fails to meet the metabolic demands of the body due to an underlying systemic condition.
Warm extremities (due to increased blood flow).
Bounding pulses.
Pulmonary congestion and edema (in advanced stages).
Tachycardia and palpitations.
Low or High Output HF
High
HF can be acute or chronic
Describe (4) from each…
Acute:
MI
Virus
Drugs
Dysrhythmias
Chronic:
HTN
Valve Diseases
DM
Lng Trm Edema
Primary cause of left sided HF
Primary Cause: Left ventricle dysfunction (commonly due to hypertension, ischemic heart disease, or valvular disorders).
Symptoms of Left sided heart failure (4)
Dyspnea (shortness of breath), especially on exertion or when lying down (orthopnea).
Paroxysmal nocturnal dyspnea (PND).
Fatigue and weakness due to reduced cardiac output
.
Pulmonary congestion causing cough, crackles, and frothy sputum.
Pathophysiology: Blood backs up into the lungs due to poor left ventricular pumping, leading to pulmonary edema
Left sided HF
Complications: Pulmonary hypertension, hypoxia, and possible progression to right heart failure.
Problem…
Left sided HF
Primary Cause: Right ventricle dysfunction (often secondary to left heart failure, chronic lung diseases, or pulmonary hypertension
Right sided HF
Symptoms of Right sided HF (4)
Peripheral edema (swelling in legs and feet).
Ascites (abdominal swelling).
Jugular venous distention (JVD).
Hepatosplenomegaly (enlargement of the liver and spleen).
Fatigue due to impaired venous return and decreased cardiac output.
Pathophysiology: Blood backs up into the systemic circulation due to poor right ventricular pumping, leading to venous congestion.
Right sided HF
Fluid Congestion:
____ heart failure → Pulmonary congestion.
_____ heart failure → Systemic venous congestion.
Symptoms Location:
____ → Respiratory-focused symptoms (lungs).
____→ Peripheral and abdominal symptoms.
Fluid Congestion:
Left heart failure → Pulmonary congestion.
Right heart failure → Systemic venous congestion.
Symptoms Location:
Left → Respiratory-focused symptoms (lungs).
Right → Peripheral and abdominal symptoms.
Cough worse at night
Dyspnea
Crackles or wheezes
Pleural effusion
Pink, forthy sputum
Tachypnea
S3 S4
Which HF
Left
Cardiac output with Left sided HF
Decrease
