Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular > L27-heart Failure > Flashcards

L27-heart Failure Flashcards

1
Q

What is heart failure

A

Failure of heart to pump blood at a rate commensurate with requirements of metabolizing tissues
Common end point for many cardiac diseases
Poor prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 3 causes of heart failure

A

Inapp workload
Impaired myocyte contraction
Restricted filling of ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 2 cases of inapp workload

A

1-volume overload

2-pressure overload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cases of volume overload

A

Hypervolemia

Regurgitation/incompetent valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cases of pressure overload

A

Hypertension

Pulmonary/aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is dilated cardiomyopathy

A

causes the heart chambers (ventricles) to thin and stretch, growing larger leading to systolic heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe mitral stenosis

A

Restriction and narrowing of mitral valve

Impairment of left ventricular filling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is hypertrophic cardiomyopathy

A

disease in which the heart muscle becomes thickened (hypertrophied)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is restrictive cardiomyopathy

A

refers to a set of changes in how the heart muscle functions(impaired relaxation). These changes cause the heart to fill poorly (more common) or squeeze poorly (less common). Sometimes, both problems are present.
Fibrosis/amyloidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the causes of restricted filling of ventricles

A 
Mitral stenosis
Hypertrophic cardiomyopathy 
Impaired relaxation:
Restrictive cardiomyopathy 
Pericardial constriction(thickening)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe ischemic heart disease

A

Coronary atherosclerosis

Damage to myocardium and scar tissue formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What causes systolic dysfunction

A 
Inadequate myocardial contractile function:
Ischemic heart disease
Dilated cardiomyopathy 
Increased preload:
Mitral/tricuspid regurge
Aortic/pulmonary regurge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What causes diastolic dysfunction

A 
Restricted filling:
Mitral or tricuspid stenosis
Hypertrophic cardiomyopathy 
Impaired relaxation:
Restrictive cardiomyopathy 
Constrictive pericarditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Result of combined systolic and diastolic dysfunction

A

Increased after load:
Hypertension
Aortic valve stenosis
Concentric hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Difference between systolic and diastolic heart failure

Bp,myocardial hypertrophy,ESV,EDV

A 
Systolic
Bp:low-normal-high
Myocardial hypertrophy:eccentric:longer muscle fibers
ESV:high
EDV:high
Diastolic:
Bp:low-normal-high
Myocardial hypertrophy:concentric:thicker muscle fibers
ESV:low
EDV:normal or low
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does frank starling mechanism correlate to cardiac output

A 
When EDV inc
Dilatation of ventricle occurs
Inc cardiac myofiber stretching
Inc force of contraction
Inc cardiac output
17
Q

Describe compensated heart failure

A

▪️Patient may remain asymptomatic or minimally symptomatic
Mechanism of compensation:
▪️Inc in preload to restore resting stroke vol to normal levels
▪️Combination of sympathetic nervous system and renin angiotensin system
▪️Compensatory hypertrophy
▪️Limitation on ability to inc stroke vol above resting levels
▪️Manifests as exercise limitation

18
Q

Describe decompensated heart failure

A

▪️When compensatory mechanisms fail to inc cardiac output
▪️Plateau:further inc in EDV does not produce a corresponding inc in force of contraction of ventricle resulting in ▪️inadequate cardiac output
▪️Patients develop symptoms
▪️Outcome:may rapidly lead to death

19
Q

What are the outcomes of heart failure

A

▪️Right sided(cor pulmonale): pulmonary hypertension
Lung diseases
▪️Biventricular: right sided heart failure due to left sided heart failure
▪️Left sided: ischemic heart disease
Systemic hypertension
Mitral or aortic valve disease
Primary diseases of myocardium(ex amyloidosis)

20
Q

Most common form of heart faiulre

A

Left ventricle systolic failure

21
Q

Effects of left sided heart failure

A 
Raised pulmonary capillary pressure
Raised left atrial pressure
Left ventricular preload is increased
Backward failure
Forward failure
inadequate cardiac output
Renal hyoperfusion 
Activation of renin angiotensin system
Hypoxic encephalopathy(irritability and coma)
Accumulation of nitrogenous wastes
22
Q

What is backward failure

A

One of the ventricles fails to pump out all of its blood that comes into it. Thus, the ventricular filling pressure and systemic or pulmonary edema increase+dyspnea
Leads to hemosiderin laden macrophages

23
Q

What is pulmonary edema

A

Dec gas exchange resulting in arterial hypoexmia

24
Q

What are the morphological changes in left sided heart failure in lungs

A

Grossly:heavy and congested
Microscopically: accumulation of edema
Fluid in the alveolar spaces
Heart failure cells:alveolar macrophages phagocytose extravasated RBCs from leaky capillaries

25
Q

What are the morphological changes in left sided heart failure in heart

A

Grossly:depend on underlying cause
Left ventricular hypertrophy/dilatation
No hypertrophy due to mitral stenosis or restrictive cardiomyopathies
Microscopically: myocyte hypertrophy with interstitial fibrosis of variable severity

26
Q

Clinical features of left sided heart failure

A 
Onset is gradual but may be abrupt 
Dyspnea on exertion 
Orthopenea 
Paroxysmal nocturnal dyspnea
Cough with blood tinged sputum 
Auscultation:
Pulmonary crackles(edema) at base of lung
Diminished s1+s2 and occurrence of s3 at apex
Cyanosis
27
Q

What is orthopnea

A

Dyspnea when recumbent

the supine position increases Venous return from the lower limbs and elevates the diaphragm

28
Q

What is paroxysmal nocturnal dyspnea

A

Extreme dyspnea with the feeling of suffocation that wakes patient from sleep

29
Q

What is cyanosis

A

Low organ perfusion decrease gas exchange

30
Q

What are the effects of right heart failure

A

▪️Pressure back through the vena cava and peripheral veins and capillaries ▪️raised right atrial pressure
▪️combination of hepatic congestion and portal hypertension can lead to peritoneal transudates (ascites)
▪️backward failure
▪️pitting edema

31
Q

Morphology of right sided heart failure in lung

A

▪️No pulmonary parenchymal edema or congestion

▪️Systemic venous congestion due to right sided heart failure to transudates(effusions) in to pleural space

32
Q

Morphology of right sided heart failure in heart

A

▪️RA dilation
▪️RV dilation
▪️RV hypertrophy
▪️In cor pulmonale,myocardial hypertrophy and dilation generally
▪️Systemic venous congestion due to right sided heart failure can lead to transudates(effusions) in the pericardial spaces

33
Q

What happens to liver (morphology) in right sided heart failure

A

▪️Congestive hepatomegaly: heavy and congested liver
▪️Cut section:congested central areas surrounded by peripheral paler,non congested parenchyma:nutmeg liver
▪️In severe long standing right sided heart failure,the central areas become fibrotic creating cardiac cirrhosis
▪️can also lead to elevated pressure in portal vein and its tributaries(portal hypertension)
▪️with vascular congestion,the spleen becomes tense and enlarged(congestive splenomegaly)

34
Q

Clinical features of right sided heart failure

A 
▪️distended jugular veins
▪️abdominal enlargement:
Hepatic enlargement 
Splenic enlargement 
Ascites 
▪️pleural/pericardial effusion
▪️peripheral/dependent/pitting edema
Ankle swelling is specifically a characteristic of right heart failure(standing or seated)
Sacral edema(supine)
35
Q

Describe biventricular heart failure

RHF due to LHF

A 
▪️Raised pulmonary artery pressures
▪️Raised pulmonary capillary pressure
▪️Backward failure
▪️Raised left atrial pressure
▪️Left ventricular preload is increased
▪️ventricular and atrial septal defect
36
Q

Clinical picture of biventricular heart failure

A 
▪️Dyspnea and fatigue
▪️Orthopnea
▪️Paroxysmal nocturnal dyspnea 
▪️Cough with blood tinged sputum
▪️Pulmonary crackles(edema)at base of both lungs
▪️Diminished s1 and s2 and s3 occurs 
▪️Cyanosis 
▪️Distended jugular veins
▪️Abdominal enlargement:
▪️Hepatic enlargement 
▪️Splenic enlargement 
▪️Ascites
▪️Pleural/pericardial effusion
▪️Peripheral/dependent/pitting edema
▪️Ankle swelling
▪️Sacral edema(supine)

Cardiovascular (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions