Lecture 6: Heart Failure

Question 1

What are some signs of a fall in CO?

Answer 1

Cool extremities, fall in rectal temperature, weakness/syncope, clow CRT, arrhythmias, reduced mentation/confusion, along with congestive failure signs

Question 2

Which body systems are activated following fall in CO?

Answer 2

RAAS, ANP and BNP release, sympathetic NS

Question 3

Where are ANP and BNP stored and released?

Answer 3

Myocardium

Question 4

What is the function of releasing ANP and BNP?

Answer 4

Natriuretics and vasorelaxants - buffer RAAS and sympathetic systems

Question 5

What are three consequences of catecholamine increase?

Answer 5

No sinus arrhythmia, reduced vagal restraint on heart, so HR increases

Question 6

What can owners monitor for as the first sign of fall in CO?

Answer 6

Tachycardia when sleeping

Question 7

What is eccentric hypertrophy?

Answer 7

Volume overload, increased thickness and radius

Question 8

What is concentric hypertrophy?

Answer 8

Pressure overload, extremely increased thickness and decreased radius

Question 9

What are the five causes of heart failure?

Answer 9

Diastolic failure, abnormal rate/rhythm, pressure overload, volume overload, myocardial failure

Question 10

Which species especially gets compliance/diastolic failure?

Answer 10

Cats

Question 11

What is compliance/diastolic failure?

Answer 11

Prevent adequate ventricular relaxation

Question 12

Which heart rate can provoke cardiomyopathy over a long period?

Answer 12

Tachycardia

Question 13

What causes a systolic dysfunction?

Answer 13

Decreased contractility

Question 14

What causes a diastolic dysfunction?

Answer 14

Decreased relaxation

Question 15

Is it forward or backwar failure where signs vary depending on the side?

Answer 15

Backward

Question 16

What is class 1 congestive heart failure?

Answer 16

No signs, but clinical evidence of heart disease

Question 17

What is class 2 congestive heart failure?

Answer 17

Exercise intolerance or dyspnoea after marked exercise

Question 18

What is class 3 congestive heart failure?

Answer 18

Marked exercise intolerance, dyspnoea after mild exercise

Question 19

What is class 4 congestive heart failure?

Answer 19

Cannot exercise, dyspnoea at rest

Question 20

What are the four stages of diastole?

Answer 20

Isovolumetric relaxation, rapid early mitral flow, diastasis, atrial contraction

Question 21

Which two conditions delay relaxation of the heart?

Answer 21

Ventricular hypertrophy, abnormal calcium movement

Question 22

Which four factors affect chamber stiffness and compliance?

Answer 22

Fibrosis, ischaemia, hypertrophy, tamponade

Question 23

What are some causes of ventricular hypertrophy?

Answer 23

HCM, aortic stenosis, pulmonic stenosis, heartworm, systemic hypertension

Question 24

What are five causes of diastolic dysfunction?

Answer 24

Ventricular hypertrophy, obstruction to ventricular filling, AV valve stenosis, intracardiac neoplasia, pericardial disease

Question 25

Which diuretics can you use for heart failure?

Answer 25

Loop, thiazine, K-sparing

Question 26

Which other drugs can you use in heart failure?

Answer 26

Vasodilators and ACE inhibitors

Question 27

How can you improve diastolic filling?

Answer 27

Control heart rate, abolish arrhythmia, improve ventricular relaxation

Question 28

How can you improve contractility?

Answer 28

Digitalis, sympathomimetics, calcium sensitizers