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(3) Cardio-Pulmo-Renal Rehabilitation > S2 L3.1: Heart Failure (Overview, Mechanisms, Causes, & Etiology) > Flashcards

S2 L3.1: Heart Failure (Overview, Mechanisms, Causes, & Etiology) Flashcards

1
Q

A complex heart clinical syndrome characterized by dysfunction of the LV, RV or both and changes in neurohumoral regulation

A

Heart Failure

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2
Q

Heart Failure is accompanied by (3)

A
  1. Effort Intolerance
  2. Fluid Retention
  3. Shortened Survival
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3
Q

Most characteristic symptom of Heart Failure

A

easy fatigability or effort intolerance

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4
Q

T/F: Not all heart failure is failure to pump blood outside
the heart

A

True

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5
Q

Most common cause of Heart Failure

A

Myocardial dysfunction or damage

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6
Q

Statement 1: The heart must pump blood abnormally to be considered as Heart Failure
Statement 2:Part of the definition of heart failure is being unable to deliver the needed metabolic requirements in the periphery

a. TF
b. FT
c. TT
d. FF

A

b. FT
In certain cases, the heart can pump blood normally but can still be called heart failure

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7
Q

If the muscles need oxygen, and we don’t have enough ___ (vehicles of oxygen) → lack of ___ → will be insufficient, called as heart failure

A
  1. Hemoglobin
  2. Oxygen
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8
Q

Unable to deliver enough oxygen, ___, ___, other needs in the periphery → can also be described as heart failure

A
  1. Vitamins
  2. Minerals
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9
Q

Which mechanisms would be overwhelmed or exhausted

A

Compensatory hemodynamic and neurohumoral mechanisms

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10
Q

The heart loses its ability to pump enough blood to meet the body’s needs resulting to:

A
  1. Weak or damaged ventricular walls
  2. Stiff & thickened ventricular walls
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11
Q

(L) ventricle does not deliver enough oxygen-rich blood to the body = ?

A

easy fatigability & SOB

LEFT-SIDED HEART FAILURE

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12
Q

(L) ventricle also increases the BP in a blood vessel between the lungs & (L) ventricle → ↑ pressure forces fluid out of the blood & into the lung tissues = ?

A

SOB (difficulty in breathing)

LEFT-SIDED HEART FAILURE

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13
Q

(R) ventricle is unable to contract w/ enough force to push blood to the lungs resulting in a build-up of
blood in the veins → ?

A

edema

RIGHT-SIDED HEART FAILURE

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14
Q

Statement 1: Overtime, HF on either side of the heart results in a weakened & enlarged ventricles that deliver more blood
Statement 2: To make-up for the ↑ amount of blood, the NS releases stress hormones that dec the speed & force of heartbeat

a. TF
b. FT
c. TT
d. FF

A

d. FF
1: Deliver less blood
2: Less amount of blood; inc speed

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15
Q

Most common cause of HF

A

Coronary Artery Disease (CAD)

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16
Q

Medications that reduce the swelling (edema) in the body by increasing the amount of urine produced by the kidneys

A

Diuretics

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17
Q

Medications that allow the blood vessels to expand to decrease BP & prevents further damage to the heart by making it easier for the heart to pump blood

A

ACE inhibitors

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18
Q

Medications that block the effect of stress hormones on the heart; although they slow down the heartbeat, they are mainly used to protect the heart muscles from the long-term damage caused by stress hormones.

A

Beta Blockers

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19
Q

Very important chamber of the heart since it’s the one pumping blood to the periphery

A

Left Ventricle

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20
Q

This phase is when the Heart is actively pumping blood out of the heart

A

Systolic Phase

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21
Q

This phase is when the Heart is getting filled with blood; during ventricular filling

A

Diastolic Phase

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22
Q

The volume of blood at the end of ventricular filling

A

End-Diastolic Volume

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23
Q

Hemodynamic Adaptations

↑ Ventricular end-diastolic volume and pressure

  1. Event in Systole
  2. Event in Diastole
A
  1. When the heart fails to pump the blood out of the heart, there would be more blood retained in the heart at the end of systole
  2. More blood is retained thus increasing the volume in the heart during diastole while a continuous floow of blood in the hear during diastole.
24
Q

Hemodyanmic Adaptations

What makes ↑ Ventricular end-diastolic volume and pressure do to make the heart work worse?

A

Blood adds up in the heart d/t increase amount of blood in the chambers resulting to increase volume and pressure

25
Q

Hemodynamic Adaptations

What adaptation is this?
Because of this inability of the heart to empty, a sufficient amount of blood out into the circulatory system, there would be increase volume in the left ventricle, left atrium, and areas before left atrium (pulmonary veins, pulmonary bed)

A

↑ Atrial volume and pressure

26
Q

T/F: An increase in volume would lead to an increase in pressure

A

True
This increase would add more burden to the heart when it comes to its pumping function

27
Q

Hemodynamic Adaptations

This law states that if you increase the volume and pressure inside a chamber, you will increase its ability to stretch or to recoil

A

Starling’s Law (↑ Atrial and ventricular contractility)

28
Q

T/F: During the early parts of heart failure, if you increase the volume and pressure in the chambers, you will also decrease the reflex of the heart muscles to contract more in an effort to eject more blood out of the heart

A

False
There will be an increase of the reflex of the heart muscles

29
Q

Hemodynamic Adaptations

Inc volume and pressure in the (L) side of the heart =

A

↑ adjacent venous system

30
Q

Two cable systems that drain used blood into
the right side of the heart

A

IVC & SVC

31
Q

↑ Capillary pressure and secondary transudation of fluid is d/t?

A

↑ volume and pressure in the venous system

32
Q

Where arterial and venous meet & exchange of blood happens

A

Capillaries

33
Q

Pressure in the capillaries → ? → fluid will now sip into the interstitial space

A

Escape of fluid from capillary system (because the venous system can no longer hold the increased amount of volume)

34
Q

↑ Interstitial and extracellular fluid volume can be manifested by ?

A

Bipedal Edema

35
Q

a. Grade 1
b. Grade 2
c. Grade 3
d. Grade 4

Edema goes up to the thigh level

A

c. Grade 3

36
Q

a. Grade 1
b. Grade 2
c. Grade 3
d. Grade 4

Edema that only reaches the ankle; early part

A

a. Grade 1

37
Q

a. Grade 1
b. Grade 2
c. Grade 3
d. Grade 4

(Anasarca): edema on the entire body

A

d. Grade 4

38
Q

a. Grade 1
b. Grade 2
c. Grade 3
d. Grade 4

Edema goes up to the knee level

A

b. Grade 2

39
Q

Other than the arterial and venous system, what system also handles the fluid in the body?

A

Lympathic System

40
Q

T/F: ↑ in volume and pressure in venous system, there will also be an excess of volume in the Lymphatic system → contributes to the edema

A

True

41
Q

Order of Sequence in Myocardial Dysfunction & Neurohormonal Mechanisms

Part 1
a. Activation of RAS and ANS
b. Myocardial Dysfunction
c. Myocardial Insult
d. Increased Load reduced systemic perfusion

A

C - B - D - A

42
Q

What are the 3 pathways of Growth and Remodelling?

A
  1. Ischemia or Energy Depletion
  2. Apoptosis or Cell Death
  3. Altered Gene Expression
43
Q

What compensatory mechanisms will be stimulated in HF? (2)

A
  1. Adrenergic System
  2. Renin-Angiotensin System
44
Q

What happens when the adrenergic system is stimulated?

A

SNS and catecholamines will increase to increase HR & BP

45
Q

What happens when the Renin-Angiotensin system is stimulated?

A

It will increase volume and vasoconstrict the blood vessels thus increasing wall stress and myocardial oxygen demand leading to more myocyte damage

46
Q

Causes of Heart Failure

What are the 2 mechanical abnormalities that causes heart failure?

A
  1. Pressure overload d/t too much fluid coming into the heart
  2. Volume Overload leading to increase in pressure
47
Q

There is insufficient blood that fills the left ventricle → insufficient ejection of blood by left ventricle

A

Mitral Stenosis

48
Q

Condition where if the pericardium gets thicker and inflamed, it constricts the heart and limits the ability of the heart to get filled with blood but can still pump blood

A

Constrictive Pericarditis

49
Q

Condition where if the myocardium (left ventricle) gets so thick, the chamber of the heart practically gets smaller → less blood that gets filled in the left ventricle

A

Left Ventricular Hypertrophy

50
Q

Condition where if contractile myocardium gets fibrotic because of
some viral infection or any infection or infiltration of foreign substances like iron or sarcoid, as long as the heart muscle is rendered fibrotic, it will no longer be able to contract.

A

Endomyocardial Fibrosis

51
Q

Myocardial Disease

Primary or Secondary?

Duchenne Muscular Disease

A

Primary

52
Q

Myocardial Disease

Primary or Secondary?

CAD - still most common cause of heart failure

A

Secondary

53
Q

Myocardial Disease

Primary or Secondary?

myocardial muscles itself is weak; can be congenital

A

Primary

54
Q

Myocardial Disease

Primary or Secondary?

Acute Rheumatic Fever

A

Secondary

55
Q

Myocardial Disease

Primary or Secondary?

Connective Tissue Diseases - scleroderma

A

Secondary

56
Q

What are the common etiologies in Heart Failure? (5)

A
  1. AMI
  2. Prolonged CV stress
  3. Toxins
  4. Infection
  5. Idiopathic
57
Q

One of the best diagnostic modalities for Heart Failure
Easy to do, inexpensive, and can diagnose fast

A

2D Echo

(3) Cardio-Pulmo-Renal Rehabilitation (34 decks)

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