Systemic Effects of CVD Flashcards
What is cardiac failure?
Failure of the heart to pump sufficient blood to satisfy metabolic demands
What is the result of cardiac failure?
Results in under perfusion which causes fluid retention and increased blood volume
What is acute heart failure
rapid onset of symptoms often with a definable cause
What is chronic heart failure?
slow onset of symptoms assocaited with ischameic or valvular heart disease
What is acute-on-chronic heart failure?
chronic failure becomes decompensated by an acute effect
What is systolic failure?
Failure of the pump to move blood during systole
- Reduced ejection fraction
- Reduced ventricular contraction
Causes of systolic failure
- Myocardial ischaemia
- Myocardial infarction
- myocardial scarring
- myocarditis
- drugs
- muscular disorders
Effects of systolic failure
- Reduced CO
- Feedback to atria and right side of the heart
- pulmonary oedema
- paeripheral oedema
What is daistolic failure?
Failure of the ventricular wall to relax
- stiff, restrictive ventricle
- Reduced ventrciular filling leads to reduced blood for systole
- Elevated end diastolic pressure
Causes of diastolic failure?
Scarring plus most causes of systolic failure
infiltrative disease e.g. amyloid
effects of diastolic failure
- none
- pulmonary and peripheral oedema
- response to exercise - tachycardia and pulmonary acute oedema
treatment of diastolic failure
Reduced AV conduction
What do right and left ventrciular failure affect respectfully?
Right = systemic circulation
Left = pulmonary circulation
Causes of right and left ventrciular failure
- Coronary heart disease
- hypertension
- cardiomyopathies
- Drugs
- Toxins
- Endocrine - diabetes, thyroid, cushing syndrome, pheochromocytoma
- Nutritional
- Infiltrative
What are the main causes of LV failure
- Hypertensive and iscahemic HF
What are the consequences of LV failure?
- pulmonary oedema
- pulmonary hypertension
- right heart failure
What is congestive heart failure?
combined right and left heart failure
What is right heart failure related to?
intrinsic lung disease
What is cor pulmonale
abnormal enlargement of the right side of the heart as a result of disease of the lungs or the pulmonary blood vessels.
Key features of clinical examination in patients with heart failure
- Appearance
- Pulse rate
- Blood pressure
- fluid overload - jugular venous pressure
- peripheral oedema - hepatomegaly, ascites
- respiratory rate, crackles, effusion
- Apex displacement, gallop rhythm, third heart sound, flow murmurs
What is the difference between transudate and exudate
Transudate is forced out of capillaries where as exudate leaks out of capillaries due to inflammation
Result of “forward” failure
- Reduced perfusion of tissues
- Tends to be more associated with advanced failure
Result of “backward” failure
- Due to increased venous pressure
- dominated by fluid retention and tissue congestion
What is hypertension a major risk for?
- CVD
- IHD
- Accelerated atherosclerosis
- Alzhimer type dementia
