Pathology of CHF

Question 1

What is CHF?

Answer 1

pump failure

Question 2

What can cause left-sided heart failure?

Answer 2

• ischemia
• HTN
• dilated cardiomyopathy
• MI
• restrictive cardiomyopathy

Question 3

What are the clinical features of left-sided heart failure?

Answer 3

pulmonary congestion due to decreased forward perfusion, leading to pulmonary edema. This results in dyspnea, paroxysmal nocturnal dyspnea (due to increased venous return when lying flat= orthopnea), and crackles.

Question 4

What are heart failure cells?

Answer 4

hemosiderin-laden macrophages that ingest blood from small, congested capillaries that burst leading to intraalveolar hemorrhage.
*brown induration of the lungs.

Question 5

To what will decreased forward perfusion in heart failure, lead?

Answer 5

decreased perfusion of kidneys= activation of renin-angiotensin system, which increases TPR, and also causes release of aldosterone from the adrenal gland, increasing blood volume and hence BP. This further exacerbates the problem of CHF :(

Question 6

What is the treatment of CHF?

Answer 6

ACE inhibitors

Question 7

**What is the most common cause of right-sided heart failure?

Answer 7

left-sided heart failure

Question 8

What are other common causes of right-sided heart failure?

Answer 8

• left-to-right shunt

- chronic lung disease (cor pulmonale)

Question 9

**What are the clinical features of right-sided heart failure?

Answer 9

• JVD
• painful hepatosplenomegaly leading to cardiac cirrhosis (fibrosis of the liver due to the heart).
• dependent pitting edema (due to increased hydrostatic pressure).