Pathology: CHF Flashcards
CHF
- How deadly is CHF?
- What is the main physiological cause of CHF?
- What are the two minor causes of CHF? (Name the associated conditions)
- Is CHF mostly acute or does pathology take a long time?
- When the failing heart can no longer efficiently pump blood, what 3 cardiac measurements increase?
CHF
- Describe the forward and backward failure seen in CHF?
- Forward failure
- Inadequate cardiac output
- Almost always accompanied by backward failure.
- Backward failure
- Increased congestion of the venous circulation - backward failure.
The cardiovascular system attempts to compensate for reduced myocardial contractility or increased hemodynamic burden through three main mechanisms.
- What are they?
Frank-Starling and CHF
- What happens to the Frank-Starling curve in CHF?
- Describe compensated heart failure.
- Why would compensated heart failure turn into decompensated heart failure?
CHF: Activation of neurohumoral systems
- What catecholamine is used to compensate for heart failure? How does it compensate?
- How is the composition of blood changed to compensate for CHF?
- How is this controlled?
CHF: Myocardial Structural Changes
- How do cardiac myocytes adapt to the increased workload seen in CHF?
Congestive Heart Failure Pathophysiology
- In pressure overload states such as hypertension or valvular stenosis, what happens to sarcomeres and muscle fibers?
- How does this affect the ventricular wall?
Congestive Heart Failure Pathophysiology
- In volume overload states such as valvular regurgitation:
- What happens to the sarcomeres?
- What happens to the ventricle?
- What does this do to the weight of the heart?
Why/How can compensatory hypertrophy in CHF cause ischemic injury?
Left-Sided Heart Failure
- What are the 4 main causes of this?
- What are the 2 physiological reasons for the morphological changes seen in this?
Left-Sided Heart Failure
- The left ventricle usually is hypertrophied and can be dilated. What types of left-sided heart failure would this not be seen in?
Left-Sided Heart Failure
- Acute Cases
- What happens to the pulmonary veins?
- What type of pressure is increased in the venules of the visceral pleura?
- How does this manifest?
Left-Sided Heart Failure: Morphology
- Chronic Cases
- What role do macrophages play?
- What are “Heart Failure” cells?
- What is the pulmonary condition that they are indicative of?
Left-Sided Heart Failure: Clinical Features
- What is the earliest symptom seen?
- Why would a patient cough with this?
- What other types of breathing symptoms would a patient have?
- What kind of heart rhythms show up?
- What do you hear when listening to the heart and lungs?
- What type of valve disease could be present?
Left-Sided Heart Failure: Clinical Features
- What happens to cardiac output?
- What does this due to the:
- Kidneys
- Pulmonary Edema
- Cerebral Perfusion
- What does this due to the:
Left-Sided Heart Failure: Treatment
- You need to treat the underlying cause of this.
- How do you do this without Rx?
- How do you reduce volume overload?
- How do you reduce afterload?
- How do you increase contractility?
Right-Sided Heart Failure
- What causes this?
- What can cause cor pulmonale, and how does this manifest in the heart?
Morphology of Right-Sided Heart Failure
- What vascular areas does significant congestion occur? How is this different that left-sided heart failure?
- What happens to the liver?
- How would this be different if a patient has both right and left heart failure?
Morphology of Right-Sided Heart Failure
- What happens to the portal vein and spleen?
Morphology of Right-Sided Heart Failure
- How do patients who have this et ascites?
- Describe the composition of effusions associated with right-sided heart failure
Morphology of Right-Sided Heart Failure
- What kind of edema is a hallmark of right-sided CHF?
- Does pure-right sided failure usually have respiratory symptoms?
- What are the clinical manifestations that are related to systemic and portal venous congestion?
