Systolic Heart Failure

Question 1

What anatomical structures are affected?

Answer 1

Left ventricle - sometimes right ventricle also.

Ventricles are dilated. According to starlings law, stretched muscles should be able to exert more force. This is true to a point until muscles become too stretched (past optimum)

Valve regurgitation (backflow of blood)

Stretching of valves

Question 2

Prior events that cause systolic heart failure?

Answer 2

Heart attack MI

Viral myocarditis - starts as resp infection, heart muscle also gets affected. Antibodies fighting the virus also damage heart muscle.

Chemotherapy drugs poison heart.

Question 3

Symptoms?

Answer 3

Fatigue 😴
Dyspnoea,
Orthopnoea (breathless when lying down)
Paroxysmal nocturnal dyspnoea (breathless @nigjt) 🌛
Nocturia (needing toilet at night) 🌛🚽
Oedema

Question 4

Signs?

Answer 4

Tachypnoea (fast resp)
Oedema
High jugular venous pressure 📈
Tachycardia 
Hypotension
Cachexia (loss if skeletal muscle mass) 
Anorexia

Question 5

Test results?

Answer 5

Echocardiogram shows dilated heart chambers

BNP brain natriuretic peptide incr

Abnormal ecg

Question 6

How to treat?

Answer 6

1) Patients should weigh themselves to test for any fluid retention.

2) loop diuretics (furosemide)
Potassium retaining diuretic (spironolactone)
ACE inhibitor
Beta blockers

3) pacemaker to resynchronise right and left ventricle contraction