Heart Failure Flashcards
(34 cards)
What is heart failure?
A syndrome encompassing different types of cardiac dysfunction resulting in inadequate perfusion of tissues with oxygen and nutrients.
This condition consists of clinical features and an objective measure of reduced ventricular function.
What is the most common cause of heart failure?
Dysfunction of the left ventricle.
However, the right ventricle may also be dysfunctional, especially in pulmonary disease.
What is the classification of heart failure based on left ventricular ejection fraction?
Heart failure with reduced LVEF (HFrEF) or heart failure with preserved LVEF (HFpEF).
The classification is made based on whether LVEF is below 50% or 50% and higher.
What is HFrEF?
Heart failure with reduced ejection fraction, characterized by reduced left ventricular systolic function and LVEF below 50%.
Formerly known as systolic heart failure.
What are the main forms of acute heart failure?
Cardiogenic shock and acute pulmonary oedema.
Acute heart failure refers to the acute onset of failure.
How is chronic heart failure diagnosed?
When the patient has had symptoms for 3 months or more.
It can be classified into left-sided and right-sided heart failure.
What is congestive heart failure?
Left heart failure, characterized by congestion due to abnormal cardiac filling.
This results in increased venous pressure, peripheral oedema, and abnormal lung sounds.
What is the New York Heart Association classification for chronic heart failure?
Ranges from Class I (no limitation) to Class IV (symptoms at rest).
Classes II and III represent graduations in between.
What is the primary clinical characterisation of HFrEF?
Heart failure symptoms with reduced LVEF below 50%.
This results in inadequate emptying of the left ventricle.
What are common causes of left ventricular dysfunction in HFrEF?
- Acute myocardial infarction
- Cardiomyopathy
- Hypertension
- Aortic stenosis
These conditions lead to reduced cardiac output.
What role do neurohumoral responses play in heart failure?
They exert direct cardiotoxicity resulting in progressive damage to the heart muscle.
This includes changes in the renin-angiotensin-aldosterone system, catecholamines, and natriuretic peptides.
What is the Frank-Starling law of the heart?
Describes the relationship between end-diastolic volume and stroke volume in the ventricle.
In a normal heart, increases in end-diastolic volume cause an increase in stroke volume.
What happens to preload and contractility in heart failure?
Increased preload leads to further decreases in contractility, worsening cardiac output.
Increased preload can initially improve cardiac output, but excessive preload results in dysfunction.
What are the clinical manifestations of HFrEF?
- Dyspnoea
- Orthopnoea
- Cough of frothy sputum
- Fatigue
- Decreased urine output
- Oedema
Physical examination may reveal pulmonary oedema and hypotension or hypertension.
What is the primary goal of managing HFrEF?
To interrupt the cycle of decreasing contractility, increasing preload, and increasing afterload.
Management includes increasing contractility and reducing preload and afterload.
What are recommended medications for HFrEF with moderate or severe reduction in LVEF?
- ACE inhibitors
- Beta blockers
- Mineralocorticoid receptor antagonists (MRAs)
These medications are recommended unless contraindicated or not tolerated.
What characterizes heart failure with preserved left ventricle ejection fraction (HFpEF)?
Heart failure symptoms with preserved LVEF of 50% or higher.
Also known as diastolic heart failure.
What is heart failure with preserved left ventricle ejection fraction (HFpEF)?
HFpEF, also called diastolic heart failure, is characterized by heart failure symptoms with preserved LVEF of 50% or higher.
What are the common pathophysiological pathways shared by HFpEF and HFrEF?
Decreased compliance of the left ventricle, stiffening and hypertrophy of the left ventricle, and increased left ventricular end-diastolic pressure.
What are major causes of diastolic dysfunction in HFpEF?
- Hypertension-induced myocardial hypertrophy
- Myocardial ischaemia with resultant ventricular remodelling.
What symptoms do individuals with HFpEF typically present?
- Dyspnoea on exertion
- Fatigue
- Evidence of pulmonary oedema.
What underlying conditions may be present in patients with HFpEF?
- Coronary heart disease
- Hypertension
- Valvular disease.
How is HFpEF diagnosed?
Diagnosis is made initially by echocardiography, which shows poor ventricular filling with normal ejection fractions.
What is the primary goal of managing HFpEF?
Improving symptoms and quality of life.
