CHF 12/02 Flashcards
What are causes of Left sided HF?
Ischemia, hypertension, dilated cardiomyopathy, MI, restrictive cardiomyopathy.
What are clinical features of Left sided HF?
Pulmonary edema –> orthopnea, dyspnea, paroxysmal nocturnal dyspnea, crackles.
In which HF are seen hemosiderin-laden macrophages?
Left sided HF.
What happens with small pulmonary capillaries in Left sided HF?
Small, congested capillaries may burst –> itraalveolar hemorrhage –> hemosiderin-laden macrophages.
What effect is on kidney in Left sided HF?
Decreased heart pump function –> decreased blood flow to kidneys –> activation of renin angiotensin system –> fluid retention –> exacerbates CHF.
What are causes of Right sided HF?
Most offen because of left sided heart failure. Cor pulmonale, left to right shunt. Important due to pulmonary cause.
What are clinical symptomes of Right sided HF?
Jugular venous distension; Hepatomegaly (nutmeg liver); Pitting edema.
Why there is peripheral edema in Right sided HF?
Increased venous pressure –> fluid transudation. Basically due to increased hydrostatic pressure.
What hepatic disease can occur in Right sided HF?
,,Cardiac cirrhosis”.
What is mechanism of heart failure?
Cardiac pump dysfunction –> congestion and low perfusion.
What is treatment of HF?
ACE inhib. or ATII blockers. Beta blockers (except in acute decompensated HF), spironolactone.
When are not used beta blockers in HF?
In acute decompensated HF.
What can increase symptoms and mortality in HF?
Hydralazine with nitrate therapy.
What is EF and EDV in systolic dysfunction?
Reduced EF; increased EDV.
What is EF and EDV in diastolic dysfunction?
Preserved EF; normal EDV.
