Norton - HF

Question 1

Obstruction of flow leads to increase in _____

Answer 1

afterload

Question 2

regurgitant flow leads to increase in

Answer 2

preload

Question 3

Frank starling mechanism

Answer 3

increased preload causes dilation and increased contractility

Question 4

Neurohumoral system activation as part of heart compensation

Answer 4

NE
RAA system
ANP

Question 5

What precedes heart failure?

Answer 5

Hypertrophy

Question 6

Causes for cardiac hypertrophy

Answer 6

increased mechanical workload

Trophic signals

Question 7

How does hypertrophy occur

Answer 7

protein synthesis is stimulated – more sarcomeres

Question 8

What are two patterns of hypertrophy

Answer 8

Concentric - pressure overload

Volume overload

Question 9

Increased cavity diameter is seen in

Answer 9

Volume overload hypertrophy

Question 10

New sarcomeres in concentric vs volume hypertrophy

Answer 10

Concentric - parallel

Volume - in series with existing

Question 11

In volume overload, wall thickness is ____ whereas in in concentric, it is ______

Answer 11

Volume - varies

Concentric - increased thickness

Question 12

_______ hypertrophy is risk factor for sudden death

Answer 12

LV

Question 13

What is a key issue with cardiac hypertrophy

Answer 13

No inc in # of capillary with increased size of myocytes. BUT they require more oxygen/nutrients (Mitochondria)

Question 14

S wave in LVH

Answer 14

greater than 30 mm in V2 and V3

Question 15

physiologic hypertrophy is different in that capillaries

Answer 15

increase in density

Question 16

what type of hypertrophy does aerobic exercise cause

Answer 16

Volume-load type

Question 17

what type of hypertrophy does static exercise cause

Answer 17

Pressure type

Question 18

cause for concentric hypertrophy

Answer 18

hypertension

aortic stenosis

Question 19

cause for volume hypertrophy

Answer 19

mitral or aortic valve regurgitation

Question 20

Changes occur _____ to heart

Answer 20

distant

Question 21

forward failure

Answer 21

poor perfusion

Question 22

backward failure

Answer 22

pulmonary, peripheral edema

Question 23

CV system is a ____ circuit

Answer 23

closed

hence L-sided failure – > R-sided failure

Question 24

Most patients present with clinical syndromes of _____

Answer 24

both R-sided/L-sided HF

Question 25

Causes - L-sided HF

Answer 25

IHD Htn Aortic/mitral valvular disease Nonischemic myocardial dz

Question 26

Result of L-sided HF

Answer 26

congestion w/in pulm circ | dec periph BF

Question 27

CHF is most often due to

Answer 27

Systolic dysfunction (contractile)

Question 28

Systolic dysfunction

Answer 28

insufficient CO, dec EF

Question 29

what other cardiac dysf show systolic dysf

Answer 29

IHD Htn Dilated cardiomyopathy

Question 30

Diastolic dysf

Answer 30

failure to relax, expand, fill dec SV, can't respond to increased demand

Question 31

what other cardiac issues show diastolic dysf

Answer 31

Massive LVH myocardial fibrosis Constrictive pericarditis

Question 32

most common cause for R-sided HF

Answer 32

Left-sided HF

Question 33

Cor pulmonale

Answer 33

pure right-sided failure Due to parenchymal dz of lungs OR disorder of pulm vasculature

Question 34

Disorders of pulmonary vasculature

Answer 34

Primary pulm htn, recurrent pulm embolus, dz causing hypoxia (Obs sleep apnea, altitude sickness)