Week 6: Defining Heart Failure Flashcards
(T/F) Heart failure is an event brought on by a combination of acute and chronic long term health conditions
False. HF is not an event
What leads to an increased risk in mortality and HF (reduced function)
50% 5y mortality rate, most will pass away by 5 years. This risk increases with each hospitalization especially following 3 admissions
Define- to the best of your ability the condition referred to as heart failure
A syndrome characterized by the inability of the myocardium to pump enough blood to meet the needs of the body
Does HF involve pumping or filling of the heart ?
Either and sometimes both
List a few of the most common causes of heart failure
CAD, MI, hypertension, valvular disease, rheumatic disease, CHD, pulmonary HTN, PE, infiltrative disorders, pericardial disease, inflammation, cardiomyopathy, dysrhythmias, medication use
What 3 systems are recruited in a myocardial injury?
SNS, RAAS, natriuretic peptide system
Describe the compensatory mechanism of the SNS in HF?
Elevation in sympathetic activity and an increase in HR and contractility
Describe the changes in the neural hormonal response with HF
Aim is to increase blood volume and elevate preload
-Increase in salt/water retention
-Post-pit secretes ADH
-Make endothelin
-Cytokines
Endothelin
Potent vasoconstrictor released with increased SNS activity in HF
Proinflammatory cytokines
Released by the heart to cause hypertrophy, contractile dysfunction, and cell death
Frank Starling mechanism
Ventricular dilation
-Increases pressures result in increased volume at the end of diastole
-Increased stretch which is initially adaptive but then leads to overstretch
Ventricular hypertrophy
Compensatory response to HF, increase in muscle mass and cardiac wall thickness in response to overwork and strain. This develops over time
What are the counter-regulatory mechanisms in HF ?
Natriuretic peptide system with BNP and ANP which are related in response to an increase in wall stress and volume expansion with diuretic, natriuretic, and hypotensive effects to inhibit RAAS and SNS
Describe what the NP system does
Impacts salt and water handling, pressure regulation and may influence myocardial structure and function
Brain natriuretic peptide (BNP)
A natriuretic hormone released from the heart especially the ventricles
Atrial natriuretic peptide
ANP, a hormone released by the myocardial cells in the atria
Over time, the compensatory mechanisms become…
Maladaptive
What promotes congestion and edema in HF?
Elevated diastolic pressure transmitted to the atrial, pulmonary, systemic venous circulations promotes these conditions
There is an increase in (R/L) after load that can _________ cardiac function and increase the rate of __________ in myocardial function
Left, depress, deterioration
What provokes coronary ischemia?
Increase in contractility, heart rate, and LV after load
What increases the loss of myocytes and cause myocardial hypertrophy and fibrosis?
Catecholamines, angiotensin II, aldosterone
Acute heart failure
A sudden onset, no compensatory mechanisms over days and hours
Chronic heart failure
Ongoing process, months-years, progressive decrease in ventricular functioning, chronic neurological-hormonal activation leading to ventricular remodelling
What are some common symptoms of chronic heart failure?
fatigue, dyspnea, tachycardia, edna, nocturne, depression, chest pain, weight changes
