Wk 6 Cardiology Pathology Pt 2 HF Flashcards
What is cardiomyopathy?
Disease that affects the heart MUSCLE
Cardiomyopathy is usually __
idiopathic
What are possible causes of cardiomyopathy? (7)
Ischemia Hypertension Inherited disorders Infections Toxins Myocarditis Auto-immune system
What is dilated cardiomyopathy usually related to?
Ischemia Valve disease Alcohol and drugs Post or peri partum Infection
Dilated cardiomyopathy usually effects the __ ventricle
left
With dilated cardiomyopathy, there is usually a __ __
genetic link
What is hypertrophic cardiomyopathy?
The ventricle is LARGER
What is hypertrophic cardiomyopathy usually related to?
Hypertension
Patients with hypertrophic cardiomyopathy are at high risk for… (2)
Cardiac arrhythmia
Sudden cardiac death
What does hypertrophic cardiomyopathy lead to?
Decreased ejection fraction of the affected ventricle
What is restrictive cardiomyopathy?
Ventricles become resistant to filling, muscle stops working, hardens
What does restrictive cardiomyopathy generally present as?
Right sided heart failure
What is restrictive cardiomyopathy most commonly related to?
Amyloid disease
What is amyloid disease?
when an abnormal protein, called amyloid, builds up in your organs and interferes with their normal function
What is heart failure defined as?
Heart cannot pump enough oxygenated blood to meet the body’s needs
What is the most common cause of hospitalization?
When the heart can’t pump enough to meet the body’s demands, they get SOA or fluid accumulation
What 3 factors contribute to stroke volume?
Preload
Afterload
Myocardial contractility
When does cardiac output stop increasing in relation to heart rate?
Around 120 beats per minute
What is preload?
Amount of fluid in the left ventricle before it contracts
What is afterload?
Pressure the heart has to squeeze against when it contracts
Preload =
Fluid volume
High blood pressure =
High afterload
What is myocardial contractility?
Is the pump working effectively? The innate ability of the heart muscle to contract
Heart failure = __ cardiac output
decreased
Heart failure = __ myocardial contractility
decreased
Heart failure = __ preload
increased
Heart failure = __ afterload
increased
Patients with heart failure have impaired __ __
ventricular filling
When does ventricular filling occur?
During diastole (in between the contractions)
When does the heart contract?
Systole
What 4 pathological changed of heart failure
FVE
Impaired ventricular filling
Weakened ventricular muscle
Decreased ventricular contractile function
What is the main cause of heart failure?
Repeated ischemic episodes
What else can cause heart failure?
MI with or without papillary muscle rupture
COPD is associated with…
Right ventricular failure (right sided heart failure)
A dysrhythmia will…
decreased cardiac output, decreases perfusion to coronary arteries that leads to ischemia in the heart which causes heart failure
What are 4 other causes of heart failure
Valve disorders
mitral insufficiency
aortic stenosis
pulmonary embolus
What type of heart failure is a pulmonary embolus associated with?
Right sided
What are the greatest risk factors for heart failure?
Largest is hypertension, but also DM 1 and 2
Why is diabetes a major risk factor for heart failure?
Endothelial dysfunction and inflammatory processes that are thought to be associated with diabetes
Within 6 months of having a MI, what percentage of men and women will develop heart failure?
22% of men
46% of women
What female hormone is cardioprotective?
Estrogen
Heart failure is more common in…
African Americans compared to caucasians
Heart failure is the most common reason for hospitalization in people who are…
Over the age of 65
List 8 risk factors for heart failure
Age Ethnicity Genetics Diabetes Ischemic heart disease Obesity Hypertension Lifestyle: Smoking and sedentary, alcohol abuse
Why is severe anemia a risk factor for heart failure?
Coronary arteries are not getting perfused
Why are viruses a risk factor for heart failure?
Certain viral infections can cause myocarditis which weakens the heart muscle
What type of recreational drug is most commonly associated with heart failure?
Cocaine/crack
What kidney conditions are risk factors for heart failure? (4)
Excess blood volume
Edema
Hypertension
Accumulation of nitrogenous wastes
When someone has LEFT sided heart failure, the blood will back up into…
the pulmonary circulation
With RIGHT sided heart failure, blood backs up into…
the systemic circulation
What type of symptoms will someone with left sided heart failure have?
PULMONARY
What breath sounds will someone with left sided heart failure have?
Cough, crackles, wheezes
What type of sputum will someone with left sided heart failure have?
Frothy, sometimes blood tinged
What is frothy sputum that is blood tinged often referred as?
Pulmonary edema
What nocturnal symptoms will someone with left sided heart failure have?
Wake up in the middle of the night with SOA - paroxysmal nocturnal dyspnea
What position will someone with LEFT sided heart failure like to be in?
Tripod
When breathing is best in an upright position and/or tripod, what is this called?
Orthopnea
What type of heart failure is associated with COPD?
Right sided
What type of heart failure has blood back up into the vena cava?
Right sided
What type of heart failure causes blood to back up into the pulmonary veins?
Left sided
Where does right sided heart failure typically cause congestion? (3)
Jugular veins
Liver
Lower extremities
What are 4 findings consistent with RIGHT sided heart failure?
JVD
Dependent edema
Weight gain
Hepatoslenomegaly (enlarged spleen and liver)
