Systemic Effects of CVD

Question 1

What is cardiac failure?

Answer 1

Failure of the heart to pump sufficient blood to satisfy metabolic demands

Question 2

What is the result of cardiac failure?

Answer 2

Results in under perfusion which causes fluid retention and increased blood volume

Question 3

What is acute heart failure

Answer 3

rapid onset of symptoms often with a definable cause

Question 4

What is chronic heart failure?

Answer 4

slow onset of symptoms assocaited with ischameic or valvular heart disease

Question 5

What is acute-on-chronic heart failure?

Answer 5

chronic failure becomes decompensated by an acute effect

Question 6

What is systolic failure?

Answer 6

Failure of the pump to move blood during systole

• Reduced ejection fraction
• Reduced ventricular contraction

Question 7

Causes of systolic failure

Answer 7

• Myocardial ischaemia
• Myocardial infarction
• myocardial scarring
• myocarditis
• drugs
• muscular disorders

Question 8

Effects of systolic failure

Answer 8

• Reduced CO
• Feedback to atria and right side of the heart
• pulmonary oedema
• paeripheral oedema

Question 9

What is daistolic failure?

Answer 9

Failure of the ventricular wall to relax

• stiff, restrictive ventricle
• Reduced ventrciular filling leads to reduced blood for systole
• Elevated end diastolic pressure

Question 10

Causes of diastolic failure?

Answer 10

Scarring plus most causes of systolic failure

infiltrative disease e.g. amyloid

Question 11

effects of diastolic failure

Answer 11

• none
• pulmonary and peripheral oedema
• response to exercise - tachycardia and pulmonary acute oedema

Question 12

treatment of diastolic failure

Answer 12

Reduced AV conduction

Question 13

What do right and left ventrciular failure affect respectfully?

Answer 13

Right = systemic circulation

Left = pulmonary circulation

Question 14

Causes of right and left ventrciular failure

Answer 14

• Coronary heart disease
• hypertension
• cardiomyopathies
• Drugs
• Toxins
• Endocrine - diabetes, thyroid, cushing syndrome, pheochromocytoma
• Nutritional
• Infiltrative

Question 15

What are the main causes of LV failure

Answer 15

• Hypertensive and iscahemic HF

Question 16

What are the consequences of LV failure?

Answer 16

• pulmonary oedema
• pulmonary hypertension
• right heart failure

Question 17

What is congestive heart failure?

Answer 17

combined right and left heart failure

Question 18

What is right heart failure related to?

Answer 18

intrinsic lung disease

Question 19

What is cor pulmonale

Answer 19

abnormal enlargement of the right side of the heart as a result of disease of the lungs or the pulmonary blood vessels.

Question 20

Key features of clinical examination in patients with heart failure

Answer 20

• 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

Question 21

What is the difference between transudate and exudate

Answer 21

Transudate is forced out of capillaries where as exudate leaks out of capillaries due to inflammation

Question 22

Result of “forward” failure

Answer 22

• Reduced perfusion of tissues
• Tends to be more associated with advanced failure

Question 23

Result of “backward” failure

Answer 23

• Due to increased venous pressure
• dominated by fluid retention and tissue congestion

Question 24

What is hypertension a major risk for?

Answer 24

• CVD
• IHD
• Accelerated atherosclerosis
• Alzhimer type dementia