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Cardiovascular > Session 11 > Flashcards

Session 11 Flashcards

1
Q

Define heart failure

A

a state in which the heart fails to maintain an adequate circulation for the needs of the body despite an adequate filling pressure

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2
Q

What is the primary cause of Systolic heart failure?

A

Ischaemic heart disease

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3
Q

What are some of the other causes of Heart failure?

A

Hypertension
Dilated cardiomyopathy (Microbes/drugs)
Valvular heart disease
Arrhythmia

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4
Q

How is Starling’s law related to Heart failure?

A

Heart can no longer produce the same force or cardiac output for a given filling pressure

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5
Q

What is Class I heart failure?

A

No symptomatic limitation of physical activity

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6
Q

What is Class II heart failure?

A

Slight limitation of physical activity

No symptoms at rest

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7
Q

What is Class III heart failure?

A

Limited physical activity

No symptoms at rest

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8
Q

What is Class IV heart failure?

A

Cannot carry out physical activity
Symptoms at rest
Discomfort increases with any physical activity

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9
Q

What is congestive heart disease?

A

Where the ventricles on both sides of the heart fail.

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10
Q

Which side of the heart rarely fails in isolation?

A

The right side. It is usually the left which then causes right side as well

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11
Q

What are the 5 types of heart failure?

A 
Left sided
Right sided
Biventricular 9congestive)
Systolic
Diastolic
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12
Q

What are some of the symptoms of left sided heart failure?

A 
Fatigue
Shortness of Breath
Tachycardia
Basal pulmonary crackles
Pulmonary oedema
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13
Q

What are some of the causes of Right sided heart failure?

A 
Secondary to heart failure
Chronic lung disease
PE
Valvular disease (Tricuspid/pulmonary)
Left to right shunts
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14
Q

What are some of the symptoms of right sided heart failure?

A 
Peripheral oedema
Fatigue
Nausea
Raised JVP
Hepatic enlargement
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15
Q

Why is the Renin Angiotensin Aldosterone System (RAAS) activated in heart failure?

A

To maintain cardiac output

They make a struggling heart work harder

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16
Q

What stimulates Renin release form the Kidneys?

A

A drop in blood pressure

17
Q

What does Renin do?

A

Catalyses the reaction of Angiotensin to Angiogtensin I

18
Q

What does ACE do?

A

Convert Angiotensin I to Angiotensin II

19
Q

What does Angiotensin II do?

A

It is a powerful vasoconstrictor so causes aldosterone to be released from the Kidneys

20
Q

What does Aldosterone do?

A

Retains Na+ and H2O so increases blood volume

21
Q

How does the Sympathetic nervous system effect the Heart and vessels?

A

Vasocontictor on blood vessels acting via alpha 1 receptors

Increases Chronotrophy and Inotrophy using beta 1 receptors

22
Q

Why are ACE inhibitors used in heart failure?

A

They prevent the conversion of Angiotensin I to Angiotensin II
So indirect diuretic and vasodilator effect

23
Q

Why are Beta blockers used in heart failure?

A

Prevent sympathetic innervation of the myocardium

24
Q

What are the principles in treating heart failure?

A

Correct the underlying cause
Lifestyle changes
Pharmacological (Improve symptoms, delay progression, reduce mortality)
Treat complications

25
Q

What are the 5 groups of drugs used to treat heart failure?

A 
Beta blockers
ACE inhibitors
Ca2+ channel blockers
Organic nitrates
Cardiac Glycosides
26
Q

How do Ca2+ channel blockers help in treatment of heart failure?

A

They reduce the contractility of the myocardium

27
Q

How do Organic nitrates help in treatment of heart failure?

A

Dilatory effect so blood pressure reduces

28
Q

How do Cardiac Glycosides help in treatment of heart failure?

A

They increase the cardiac output and contractility

Inhibit Na+/K+ pump, raised Na+, NCX inhibited, Ca2+ increases, increased contractility

Cardiovascular (15 decks)

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