13. Heart Failure I: Pathophys Flashcards Preview

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Flashcards in 13. Heart Failure I: Pathophys Deck (37):
1

What can cause volume overloaded heart muscle?

mitral regurg high cardiac output holes in heart beriberi

2

What can cause cardiac muscle cell destruction?

MI viral myocarditis peripartum cardiomyopathy idiopathic cardiomyopathy alcohol

3

What does HFpEF stand for?

HF with preserved ejection fraction

4

What does PSF stand for?

preserved systolic function

5

What affects the stroke volume?

contractility, preload, afterload

5

What is systolic HF?

a problem with the squeeze; ↓contraction / ↓ inotropy decreased ejection fraction and ventricular enlargement can be heart failure with reduced ejection fraction (HFrEF), left ventricular systolic dysfunction (LVSD), or dilated cardiomyopathy (DCM)

5

What can cause overstressed heart muscle?

tachycardia-mediated HF meth abuse catecholamine mediated

6

What can cause myocardial thickening/fibrosis?

hypertrophic cardiomyopathy 1a restrictive cardiomyopathy

7

What are the 1a causes of R heart failure?

1. L sided heart failure 2. lung disease/pulmonary HTN 3. RV volume overload 4. damage to the RV myocardium

8

For patients with symptomatic HF, half will be dead within _____.

5 years

8

What are the hallmarks of diastolic HF?

1. normal ejection fraction (“HF with preserved ejection fraction” = HFpEF; “preserved systolic function” = PSF) 2. ventricular wall thickening (LVH, HCM)

10

What does DCM stand for?

dilated cardiomyopathy

11

Most heart failure involves?

the L heart

13

What are the 2 main components of HF?

poor forward blood flow (↓ cardiac output) and backward buildup of pressure/congestion (↑ filling pressures)

14

What is cor pulmonale?

when 1a lung disease causes HF

15

What is the outcome of RAAS activation?

o Vascoconstriction o Salt/water retention

17

A hypertrophied heart has ____ HF; a dilated heart has ____ HF.

hypertrophy = diastolic dilated = systolic

18

What determines inotropy?

o Catecholaminergic / adrenergic stimulation o Calcium

19

What can cause high afterload/pressure overload?

hypertension aortic stenosis dialysis (inadequate fluid removal)

19

Name 4 adverse cardiac remodeling outcomes caused by long term increased cardiac workload and metabolic demands.

o Ventricular hypertrophy o Ventricular dilation o Myocardial damage / apoptosis o Myocardial fibrosis

20

Name 2 ways the RV myocardium can get damaged.

1. isolated RV infarct 2. myocarditis

22

Heart failure is ______ to meet the metabolic demands of the body (forward failure), or the ability to do so only if the cardiac filling pressures are abnormally high (backward failure).

the inability of the heart to pump blood forward at a sufficient rate

23

o Vascoconstriction o Salt/water retention These are caused by?

RAAS activation

24

What does LVSD stand for?

left ventricular systolic dysfunction

25

Problems with relaxation cause problems with ____ (↓lusitropy / decrease in relaxation).

filling

26

What can cause external compression?

pericardial fibrosis/constructive pericarditis pericardial effusion

27

Heart failure is the inability of the heart to pump blood forward at a sufficient rate to _____ (forward failure), or the ability to do so only if the cardiac filling pressures are abnormally high (backward failure).

meet the metabolic demands of the body

28

Name 3 general causes of diastolic heart failure.

1. high afterload/pressure overload 2. myocardial thickening/fibrosis 3. external compression

29

What does HCM stand for?

hypertrophic cardiomyopathy

30

What does LVH stand for?

left ventricular hypertrophy

31

Heart failure is the inability of the heart to pump blood forward at a sufficient rate to meet the metabolic demands of the body (forward failure), or the ability to do so only if the cardiac filling pressures are ____ (backward failure).

abnormally high

32

What does HFrEF stand for?

heart failure with reduced ejection fraction

33

HFrER, LVSD, and DCM are all?

systolic HF

34

The median age for CF pts is ___.

75yo

35

o Vasocontriction o Tachycardia o Inotropic augmentation All are caused by?

adrenergic activation

36

What is the outcome of adrenergic activation?

o Vasocontriction o Tachycardia o Inotropic augmentation

37

What causes systolic HF?

o destruction of heart muscle cells (MI, viral myocarditis, peripartum cardiomyopathy, idiopathic cardiomyopathy, alcohol) o overstressed heart muscle (tachycardia-mediated HF, meth abuse, catecholamine mediated) o volume overloaded heart muscle (mitral regurg, high cardiac output, holes in heart, beriberi)