MP323 - HEART FAILURE Flashcards

1
Q

heart failure

A

characterised by impaired cardiac pumping such that the heart is unable to pump adequate amount of blood to meet metabolic needs

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2
Q

signs and symptoms of HF

A

shortness of breath
excessive tiredness
leg swelling

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3
Q

congestive HF - left-sided failure

A
  • most common form
  • blood backs up through the left atrium into the pulmonary veins
  • pulmonary congestion and oedema
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4
Q

congestive HF - right-sided failure

A
  • rare
  • associated with pulmonary hypertension
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5
Q

stroke volume

A

the volume of blood pumped from one ventricle of the heart with each beat

the difference between end-diastolic volume (EDV) and end-systolic volume (ESV)

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6
Q

increased preload on SV

A

preload increased
EDV increases
increased stroke volume

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7
Q

increased afterload on SV

A

afterload increased
ESV increased
decreased stroke volume

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8
Q

increased contractility on SV

A

contractility increased
ESV reduced
increased stroke volume

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9
Q

effect of HR on cardiac output

A

higher the heart rate, the higher the cardiac output
HR x SV = CO

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10
Q

preload

A
  • the amount of fibre stretch in the ventricles at the end of diastole (before next contraction)
  • directly related to ventricular filling
  • higher end-diastolic volume implies higher preload
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11
Q

preload increases with…

A
  • increased in blood volume
  • vasoconstriction
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12
Q

preload decreases with…

A
  • loss in blood volume
  • vasodilation
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13
Q

Starling’s law

A
  • relationship between preload and cardiac output

excessive preload = excessive stretch - reduced contraction - reduced SV and CO

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14
Q

afterload

A
  • the resistance against which the ventricle must pump

excessive afterload = difficult to pump blood - reduced SV and CO

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15
Q

afterload increases with…

A

hypertension
vasoconstriction

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16
Q

afterload decreases with…

A

vasodilation

17
Q

contractility

A
  • ability of the heart muscle to contract
  • relates to the strength of contraction
18
Q

contractility increases with…

A

positive inotropes

19
Q

contractility decreases with…

A

infarcted tissue - no contractile strength
ischaemic tissue - reduced contractile strength

20
Q

myocardial hypertrophy

A

walls of heart thicken to provide more muscle mass - stronger contraction

21
Q

how does vasoconstriction worsen heart failure

A

increases the resistance against which heart has to pump (increases afterload), and therefore decreases CO

22
Q

how does Na+ and water retention worsen heart failure

A

increases fluid volume, which increases preload

if too much stretch (too much fluid) there is a decrease in strength of contraction and decreased CO

23
Q

how does excessive tachycardia worsen heart failure

A

decreases diastolic filling time - decreases ventricular filling - decreases SV and CO