HF Pathology Flashcards
Heart Failure
Ability of heart to pump blood is decreased leading to decrease CO
CO =
CO=SV x HR
CO=4-8 L/min
5 Factors affecting CO
Cardiac contractibility
Heart rate
Preload
Afterload
Blood volume
Chronic cause of HF
CAD
Cardiomyopathy
HTN
Pulmonary disease
Valvular Disease
Acute cause of HF
Acute MI
Myocarditis
Hypertensive crisis
Rupture of papillary muscle
Dysrhythmias
Ejection Fraction
% of end-diastolic blood volume that is ejected during systole
Normal EF is greater than 60%
HF with reduced EF
Systolic dysfunction
Most common form of HF
LV cannot contract strongly enough to pump blood into aorta
EF usually less than 40
HF with preserved EF
Diastolic Dysfunction
Inability of ventricles to relax and fill during diastole
Decrease filling = Decrease SV
High filling pressure due to poorly compliant ventricles for example too small, too stiff to relax and fill completely
Ventricular hypertrophy common
Mixed HF
Both systolic and diastolic dysfunction
HF Compensatory Mechanisms
1) SNS activation
2)Neuro-Hormonal Response
3) Ventricular Dilation
4) Ventricular Hypertrophy
SNS Activation
increase HR, contractility, peripheral vasoconstriction
They do increase CO but also increase workload
Neuro-Hormonal Response (RAAS)
Na/water retention, increase peripheral vasoconstriction, ADH cause water retention
Ventricular Dilation:
Enlargement of the heart chambers usually LV, muscle fibres of heart stretch
Initially good, but over time stretch too far and decrease CO
Ventricular Hypertrophy
Increase muscle mass and ventricular wall thickness
Acute HF
Acute HF are often due to pulmonary edema
Chronic HF
Long term HTN, less and less tolerance, SOB after walking
Left sided HF
Due to decrease CO or pulmonary congestion
Right sided HF
Due to increase systemic venous congestion
Biventricular failure
Failure of one pump will eventually cause other pump to fail
General symptom of Right sided HF
Weight gain
Increase BP
H2T for Right sided HF
Jugular vein distension
Swollen hands and fingers
Anorexia and nausea
Distended abdomen
Enlarged liver and spleen
Polyuria at night
Dependent edema
H2T for Left sided HF
- Fatigue
- Confusion, restlessness
- Tachycardia
- Angina
Oliguria
Pallor, weak - Cool extremity
Pulmonary Congestion
Cough
Dyspnea
Crackles/Wheezes
Fronthy-pink tinged sputum
Orthopnea
SOB with lying down, fluid return to central circulation when lying flat
Paroxysmal Nocturnal Dyspnea
Sudden onset on SOB at night when sleeping
Dysrhythmias
enlarged heart chambers can cause changes in electrical pathway, Afib, ventricular arrythmias
Left Ventricular Thrombus
Enlargement of LV and decrease CO
Hepatomegaly
Hepatic congestion can lead to impaired liver function
Renal Failure
Decrease perfusion can lead to renal insufficiency or failure
