Heart Failure

Question 1

Cardiomyopathy

Answer 1

Disease that affects the MYOCARDIUM (heart muscle)

Usually idiopathic, can be caused by ischemia, HTN, inherited disorders, infections, toxins, myocarditis, auto-immune issues.

Leads to: HEART FAILURE

Question 2

Dilated Cardiomyopathy

Answer 2

Related to:

• Ischemic problems
• hypertension

Question 3

Hypertrophic Cardiomyopathy

Answer 3

• High risk of arrhythmias and cardiac death
• Left ventricle is huge
• EF becomes very small

Question 4

Restrictive Cardiomyopathy

Answer 4

Rarest

• Ventricles become resistant to filling, muscle stops working (ventricle becomes hard)
• Usually Right sided HF

Question 5

What ventricle is affected in cardiomyopathy?

Answer 5

Left, right, or both

Question 6

What is Heart failure?

Answer 6

A “pump” problem

Question 7

HF definition

Answer 7

Chronic progressive condition in which the heart muscle is unable to PUMP enough blood to meet the bodies needs.
-Don’t get O2 to tissues

Question 8

Cardiac Output in HF

Answer 8

DECREASED

Question 9

Stroke Volume parts

Answer 9

Preload: amt. of volume in LV before heart contracts

Myocardial contractility: pump muscle

Afterload: Pressure heart has to squeeze against when it contracts
-Inc BP, High afterload

Question 10

HF results in…

Answer 10

Dec CO
Dec Myocardial contractility
Inc preload
Inc afterload (d/t Vasoconstriction from RASS sys)

Question 11

Development of Heart Failure

Answer 11

1. Volume Overload (fluid backup from ineffective pumping)
2. Impaired Ventricular Filling (diastole)
3. Weakened Ventricular muscle
4. Decreased Ventricular contraction function (heart contracts during systole)

Question 12

HF etiology

Answer 12

REPEATED ischemic episodes (ischemic cardiomyopathy)

• MI w/ or w/o papillary muscle rupture
• Chronic HTN
• COPD (RVF)
• Dysrhythmias
• Valve disorders (mitral insufficiency, aortic stenosis)
• Pulmonary embolism (RVF)

Question 13

Risk factors for HF

Answer 13

HYPERTENSION

• Largest risk factor
• DM can also contribute

MI (within 6 months)

• 22% men dev HF
• 46% women (diagnosed at later age, estrogen is cardioprotective)

Men and postmenopausal women have same risk of CV disease.

Higher incidence in Black individuals

Genetics!

Question 14

Other Risk Factors for HF

Answer 14

Age: increasing
-most common reason for hospitalization in people 65 and greater

Ethnicity: blacks

Family History + Genetics

Diabetes

Ischemic Heart Disease

Obesity

HTN

Lifestyle Factors
-smoking and sedentary

Question 15

Other random RF

Answer 15

COPD
Severe anemia
Congenital Heart Defects
Viruses (uncommon)
-weakens muscle (inflammation)
Alcohol/Drug abuse 
-coke/crack
Kidney Conditions