HPIM Ch 252-253 Flashcards
Heart failure (HF): a complex clinical syndrome that results from structural or functional impairment of ventricular filling or ejection of blood, which in turn leads to the cardinal clinical symptoms of 1) ___ & 2) ___ and signs of HF, namely 3) ___ & 4) ___
1) dyspnea
2) fatigue
3) edema
4) rales
Three conditions that augment risk of HF?
Coronary artery disease (CAD), hypertension (HTN), diabetes mellitus (DM)
Which is true of familial cardiomyopathy?
A) exact etiology is unknown
B) occurs in 20-30% of HF with depressed ejection fraction (EF)
C) prior viral infection/toxin exposure
D) secondary to specific genetic defects, most notably those in the myocardium
E) autosomal dominant
E is correct
A - usually referred to as non-ischemic, dilated, or idiopathic cardiomyopathy
B - ^^
C - can lead to dilated cardioyopathy
D - myocardium should be cytoskeleton
Note: Dilated cardiomyopathy is also associated with mutation of genes that encode cytoskeletal proteins (desmin, cardiac myosin, vinculin) & nuclear membrane proteins (laminin)
Choose the which of the following is an etiology of high-output states of heart failure:
A) Fibrosis B) Chronic anemia C) Cor pulmonale D) Hypertension E) Aging
B! Others: thyrotoxicosis (a metabolic disorder), nutritional disorders (beriberi), systemic arteriovenus shunting. Seldom responsible for the development of HF in a normal heart; however, in the presence of underlying structural heart disease, these conditions can lead to overt HF
For A & E - etiologies of preserved ejection fraction. Others include pathologic hypertrophy (primary & secondary), endomyocardial disorders, restrictive cardiomyopathy
(see page 1763 for more)
A frequent concomitant factor in HF in many developing countries A) HTN B) rheumatic heart disease C) diabetes D) anemia
C
Common causes of HF globally:
rheumatic heart disease - Africa & Asia
HTN - African & African-American
Chagas’ disease - South America
