Lecture 12: Heart Failure - Part 1 Flashcards
What are the 3 most common causes of HF?
- CAD - ischemic heart disease
- Idiopathic, dilated cardiomyopathy
- Valvular heart disease
What are 4 causes of restriction/obstruction to ventricular filling which can lead to HF?
- RV infarct
- Constrictive pericarditis
- Mitral stenosis
- Atrial myxoma
Using the AHA/ACC heart failure staging guidelines, what does stage A represent?
Pts at high risk for HF but WITHOUT structural heart disease or sx’s of HF
Using the AHA/ACC heart failure staging guidelines, what does stage B represent?
Asymptomatic pts WITH structural heart disease (i.e., LVH and/or impaired LV function (low EF), valvular dz, but hemodynamically stable
Using the AHA/ACC heart failure staging guidelines, what does stage C represent?
Pts WITH current or prior sx’s of HF WITH structural heart disease; SOB, fatigure, reduced exercise tolerance
Using the AHA/ACC heart failure staging guidelines, what does stage D represent?
Pts w/ refractory HF requiring specialized treatment/interventions
Using the NYHA functional classification for HF, what does class I-class IV represent?
- Class I = asymptomatic; no physical activity limitations
- Class II = no sx’s at rest; exertional sx’s w/ ordinary activity
- Class III = no sx’s at rest; sx’s with minimal activity
- Class IV = sx’s AT rest
Which imaging modality is essential in the evaluation of heart disease and for distinguishing systolic HF from diastolic HF?
Echocardiogram
List 5 causes of acute HF
- Acute MI
- Ruptured papillary muscle
- MR
- AI
- Toxins
What are some distinguishing sx’s of systolic HF vs. diastolic HF?
- Systolic HF = DOE, orthopnea, paroxysmal nocturnal dyspnea
- Diastolic HF = SOB, DOE, and pulmonary edema
Which type of HF (diastolic/systolic) is associated with HTN, obesity, DM, CAD, and aging?
Diastolic HF
What are 3 common underlying causes of imparired ventricular relaxation leading to diastolic HF?
- Acute ischemia
- Myocardial fibrosis
- Amyloidosis
List 6 causes of high-output HF?
- Hyperthyroidisim
- Anemia
- Pregnancy
- A-V fistula
- Beriberi
- Paget’s
What are the CO and EF like in high output HF?
- High CO
- Low EF
Which hormones released as a compensatory mechanism for HF causes an increased preload and which causes inceased afterload?
- Aldosterone —> Na and H2O retention = ↑ preload, congestive sx’s and volume expansion
- Angiotensin II –> vasoconstrictor –> ↑PVR (↑ afterload)