Ventricular Hypertrophy then Cardiac Failure Flashcards
how long does embryonic heart hyperplasia last for?
only first few months of life
How do you control heart hypertrophy in childhood?
Growth Hormone
IGF
Thyroxine
Mean ventricular mass?
159g
Heart size depends on 5 things
body size genetics atheletics blood pressure angiotensin II, catecholamines
When is ventricular hypertrophy considered hypertrophy?
When the ventricle mass increases RELATIVE to body size
What is ventricular remodelling?
increase wall thickness without increase in mass
Reasons for cardiac remodelling?
infarct
damage
volume overload
pressure overload
Does eccentric hypertrophy’s wall thickness change?
Nope. just the mass
LV mass increases in Concentric, eccentric hypertrophy and remodelling?
Nope. Not in remodelling
How does the heart remodel due to pressure overload?
concentric hypertrophy
How does the heart remodel due to volume overload?
eccentric hypertrophy
How are cardiac sarcomeres placed in concentric vs. eccentric hypertrophy?
concentric: parallel
eccentric: in series
T/F? Hypertrophy has more mitochondrion, more myfibrils, more myocardial cells, increased fibroendothelial cells, more matrix and more sarcoplasmic reticulum?
FALSE BITCH! Myocardial cell numbers DO NOT increase, only the SIZE increases.
What law dictates that a thicker wall reduces wall stress?
Laplace’s Law
Why is cardiac hypertrophy kinda paradoxical?
Animals with no hypertrophy actually respond better to pressure loads. Go Figure.
What happens prior to cardiac failure in a hypertrophied heart?
Decompensation from long term-ness
What’s Fabry’s Disease
Genetic cause of left ventricular hypertrophy
How would infiltration be a cause of left ventricular hypertrophy
Sneaky proteins cause amyloidosis and ninja your ass
Two signs of left ventricular hypertrophy on ECG?
inverted T-wave
Tall voltages
what could cause diastolic dysfunction?
left ventricular hypertrophy
Out of the three left ventricular hypertrophies: what’s the worst one for mortality post MI?
Concentric
Thick muscle is……
Stiff Muscle.
When does the ‘Atrial Kick’ more important?
In diastolic dysfunction
What do you lessen if you treat someone with ACE inhibitors/beta adrenergic blocking post MI?
Ventricular dilation post-MI remodelling
3 causes of Right Ventricular Hypertrophy?
- congenital
- pulmonary artery hypertension
- Right heart valves
What is hypertrophic cardiomyopathy?
Autosomal dominant, sarcomere protein mutation
What is especially thick in Left Ventricular Hypertrophy?
Septum
There is only a few presentations of hypertrophic cardiomyopathy T/F?
False. LOTS of Variability.
What is the most common cause of sudden cardiac death in athletes?
hypertrophic cardiomyopathy
We know the cause of Dilated Cardiomyopathy.
Nah. it’s idiopathic.
Athlete’s Heart’s wall thickness is greater or less than 14mm?
Less than 14mm wall thickness
what kind of hypertrophy do you find in athlete’s heart?
eccentric
What’s your cardiac output per minute?
5L/min
Starling’s Law
if you increase preload + cardiac contraction you get increased SV and CO
How is Starling’s Law regulated?
it’s intrinsic, purely by the muscle stretch
What does JVP measure?
right ventricular/atrial EDP
How to measure left atrial pressure through the right ride of the heart?
Pulmonary wedge pressure in the pulmonary artery because it equals left atrium/ventricle pressure
What is the device used to measure pulmonary wedge pressure called?
Swan-Ganz Catheter
What determines blood pressure?
The Arteriole.
Oedema is when:
Hydrostatic pressure exceeds osmotic
What pressure causes oedema?
increased venous pressure
What are forces across capillaries called?
Starling Forces
How does increased plasma protein loss leave to Oedema?
due to decreased osmotic pressure back into veins
What causes pathological increased capillary permeability leading to oedema?
infection
Name two uses for end diastolic pressure:
- measure filling of ventricles
2. measure venous pressure driving fluid out of capillaries
Define Cardiac Failure
CO can’t keep up with body’s needs. Usually systolic failure
Why would the body retain fluid to compensate for decrease cardiac output?
increases left ventricular end diastolic pressure to maintain CO. bad if >25mmHg
Why would your lungs get congested in heart failure?
Cause of fluid retention compensating to get CO up and increases in LVEDP
3 mechanisms of Cardiac Failure
- loss of myocardial muscle
- pressure overload (stenosis, HTN)
- volume overload (valve regurg)
Clinical features of right heart failure?
Oedema
Clinical fathers of left heart failure? 4 things:
SOB
fatigue
Tachycardia
lung crackles
What happens to Na+, and K+ in cardiac failure?
Na+ retention, K+ loss, vasoconstriction
When do you get liver congestion of blood?
Right heart failure
Can left heart failure cause right heart failure?
Yes it can! venous hypertension will back blood up through the pulmonary circulation and cause arterial hypertension.
How do you get diastolic heart failure?
reduced compliance from infarct or stiff walls
What is only helpful short term for cardiac failure?
Digoxin, positive inotropics
How to treat underlying cause of heart failure?
bypass valve replacement pacemaker defib transplant
