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Pathophysiology - Midterm > Lecture 4: Heart Failure > Flashcards

Lecture 4: Heart Failure Flashcards

1
Q

What does increasing preload cause?

A

Increased tension on ventricular walls, ultimately increasing oxygen demand

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2
Q

What is afterload?

A

Amount of pressure from peripheries acting on heart

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3
Q

What does a high afterload mean?

A

Hard for blood to leave heart

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4
Q

What 3 factors increase stroke volume?

A
  • Increased contractility
  • Increased preload
  • Decreased afterload
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5
Q

What is stroke volume?

A

Volume of blood ejected with each beat of the heart

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6
Q

What does increasing stroke volume do to cardiac output?

A

Increases it

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7
Q

What is vascular/peripheral resistance?

A

“Squeeze” of blood vessels outside the heart resisting blood flow

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8
Q

Describe the Frank-Starling Law

A

Preload and afterload will decrease in relation to stroke volume for a patient with heart failure

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9
Q

Why might the heart need to produce compensatory mechanisms? (Think of the highway analogy)

A
  • MI (one lane closed)

- Increased BP (traffic jam)

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10
Q

What are the 4 compensatory mechanisms?

A

1) Increased heart rate
2) Increased preload from activation of RAAS
3) Vasoconstriction
4) Ventricular hypertrophy

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11
Q

What are the pros of the compensatory mechanism of increasing heart rate?

A

Maintains CO

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12
Q

What are the pros of the compensatory mechanism of increasing preload using RAAS?

A

Increased stroke volume

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13
Q

What are the pros of the compensatory mechanism of peripheral vasoconstriction?

A

Maintains BP

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14
Q

What are the pros of the compensatory mechanism of ventricular hypertrophy?

A
  • Maintains CO

- Decreases oxygen demand

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15
Q

What are the cons of the compensatory mechanism of increasing heart rate?

A
  • Short filling time

- Increased oxygen demand

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16
Q

What are the cons of the compensatory mechanism of increasing preload using RAAS?

A
  • Edema

- Increased oxygen demand

17
Q

What are the cons of the compensatory mechanism of peripheral vasoconstriction?

A

Increased afterload causing decreased stroke volume

18
Q

What are the cons of the compensatory mechanism of ventricular hypertrophy?

A

Increased risk of ischemia and arrhythmias

19
Q

What do natriuretic peptides do?

A
  • Secreted by brain and aorta to counteract negative compensatory mechanisms in heart failure
  • Promote water loss, causing a decreased TPR
  • Inhibits aspects of RAAS
  • Vasodilation
20
Q

What is left-sided heart failure?

A

Blood is backed up in lungs

21
Q

What is right-sided heart failure?

A

Blood is backed up in abdominal organs and periphery

22
Q

What are 6 signs and symptoms of heart failure?

A

1) Fluid retention and edema
2) Shortness of breath
3) Fatigue
4) Cyanosis
5) Hypertrophy
6) Confusion

23
Q

What can fluid retention cause?

A
  • Excessive weight gain in a short period of time
  • Pitting edema (squishy feet/ankles)
  • Rales
24
Q

What is rales?

A

Crackling sounds on auscultation with stethoscope

25
Q

What can shortness of breath cause?

A
  • Increased JVP
  • Dyspnea
  • Orthopnea
  • Cough
26
Q

What is dyspnea?

A

Difficulty breathing

27
Q

What is orthopnea?

A

Difficulty breathing laying down

28
Q

What is cyanosis?

A

Oxygen depletion

29
Q

What can fatigue, cyanosis, and fatigue cause?

A

Decreased cardiac output

30
Q

What is a sign of cyanosis?

A

Blue lips, fingers, or toes

31
Q

What are 6 diagnostic tests used to diagnosis heart failure?

A

1) Chest X-Ray
2) Echocardiogram
3) JVP
4) Pulmonary edema
5) Peripheral edema
6) Ascites

32
Q

Why is a chest x-Ray used to diagnosis heart failure?

A

Look for an enlarged cardiac silhouette (over 50% increase)

33
Q

Why is an echocardiogram useful in diagnosing heart failure?

A
  • Use ultrasound to detect abnormalities in structure and function
  • Look at LVEF (left ventricular ejection fraction)
34
Q

What is a normal LVEF?

A

55-70%

35
Q

What is an LVEF normal of someone with heart failure?

A

Less than 40%

36
Q

What is JVP and why is it used for heart failure diagnostics?

A
  • Jugular venous pressure

- Elevation indicates a volume overload

37
Q

What is ascites?

A

Fluid accumulation in peritoneal space

38
Q

What are 5 non-pharmacological treatments for heart failure?

A

1) Salt restriction
2) Fluid restriction
3) Stop smoking
4) Monitor weight daily
5) Exercise once symptoms are controlled

39
Q

What is preload?

A

Stretch of ventricles when filled

Pathophysiology - Midterm (11 decks)

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