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CVS Pathology > Pathology 2: Heart Failure > Flashcards

Pathology 2: Heart Failure Flashcards

1
Q

Heart is similar to a pump, it’s composed of what components

A
  1. Control components
  2. Distribution components
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2
Q

What are the control components

A
  1. Myocardium
  2. Valves
  3. Conductive system

(Structure of the heart)

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3
Q

What are the distribution components

A
  1. Systemic circulation
  2. Pulmonary circulation
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4
Q

How does heart failure develops

A

Gradually and insidiously due to cumulative effects of disorders of various etiology

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5
Q

CO depends on what

A

SV x HR

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6
Q

What is SV

A

Amount of blood ejected from ventricle during systole

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7
Q

What is the equation of SV

A

SV = EDV-ESV

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8
Q

SV depends on what

A
  1. Preload
  2. After load
  3. Myocardial contractility
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9
Q

What is preload

A
  • It’s the amount of blood ready to be pumped by the ventricle
  • ventricular pressure at the end of diastole
  • after the filling

(Same definition)

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10
Q

What is after load

A
  • Pressure during ventricular systolic contraction
  • during ejection of blood
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11
Q

What will happen to preload in heart failure

A

Decreased

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12
Q

What happens to after load in heart failure

A

Increased

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13
Q

When will SV increase

A
  1. Increase in preload
  2. Decrease in after load
  3. Enhanced contractility
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14
Q

What are the onset of heart failure

A
  1. Acute
  2. Chronic (congestive HF) (more common)
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15
Q

What are the sides involved in heart failure

A

Left and right side

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16
Q

What are the causes of left sided heart failure

A
  1. Hypertension
  2. Ischemic heart disease
  3. Aortic stenosis
  4. Moral incompetence

(1&2 are the most common)

17
Q

How can ischemia causes heart failure

A

Atherosclerosis of coronary arteries =

less blood supply to cardiac muscle =

chronic ischemia of cardiac muscle

18
Q

How can aortic stenosis causes heart failure

A

Narrowed aortic valve

= left ventricle will eject blood against increased resistance

= eventually will fail

19
Q

How does mitral incompetence causes heart failure

A

Mitral valve isn’t closing properly

= back flow of blood during systole from left ventricle into left atrium

= left sided failure

20
Q

What are the causes of right sided heart failure

A

1.COPD
2. LSHF (most common)
3. Pulmonary stenosis
4. Tricuspid stenosis

21
Q

How can LSHF causes RSHF

A

When left side fails = pressure increase = blood accumulate in pulmonary congestion = pulmonary hypertension = edema = RSHF

22
Q

How can COPD causes RSHF

A

any condition causes pulmonary fibrosis = fibrosis will cause pressure on pulmonary vasculature = pulmonary hypertension

23
Q

What are the physiological compensatory mechanism

(Like exercising,etc)

A
  1. Dilation (to pump more blood)
  2. Increased heart rate
24
Q

What is compensatory mechanism when there’s a pathological conditions

A
  1. Increased HR
  2. Dilation
  3. Hypertrophy
  4. Neuro-hormonal (RAAS)
25
Q

What is the mechanism of dilation

A

Increased ventricle size = increase contraction force

26
Q

What is the type of dilation in physiological condition

A

Active dilation
(The ventricle aren’t forced to dilate)

27
Q

What is the type of dilation in pathological condition

A

Passive dilation

28
Q

What is the end result of passive dilation

A

= gradual decrease of contraction force = strength of muscular contraction decrease = incomplete emptying

29
Q

What happens when there’s increased heart rate in pathological conditions

A

The heart cannot empty it’s content completely = no sufficient time for complete emptying

30
Q

What is the end result of hypertrophy

A

Muscles become too big for blood supply & nutrients = incomplete emptying = further heart failure = more dilation

31
Q

What is the neurohormonal response in heart failure

A

= low CO
= + SNS & +RASS
= vasoconstriction + water & salt retention
= further stress on the failing heart
= further heart failure

32
Q

What are the effects of heart failure

A
  1. Forward effects
  2. Backward effects
  • impaired tissue perfusion
  • venous congestion
  • Edema
33
Q

What are the effects of LSHF

A
  1. Impaired tissue perfusion
  2. Pulmonary congestion & Edema
34
Q

What are the effects of RSHF

A
  1. Low output to lungs (insignificant unless due to LSHF)
  2. Systemic venous congestion
  3. Generalised Edema
35
Q

What type of effects are more significant in RSHF

A

Backward effect

36
Q

What are the causes of chronic HF

A
  1. Hypertension
  2. Ischemic heart disease
  3. COPD
  4. Valve disease
  5. Severe anemia
37
Q

What are the effects of chronic HF

A
  1. Fully developed compensatory mechanism
  2. Generalised venous congestion
  3. Generalised Edema
38
Q

What are the causes acute HF

A
  1. Coronary occlusion
  2. Pulmonary embolism
  3. Cardiac tamponade
  4. Malignant hypertension
  5. Acute mycocarditis
39
Q

What are the effects HF

A
  1. No time for compensatory
  2. Multi - organ failure
  3. Acute pulmonary Edema

CVS Pathology (7 decks)

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