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Flashcards in Heart Failure Deck (15):
1

what is the main physiologic cause of HF

↓ LV contractility

2

MCC of HF

chronic hypertension

*ischemic cardiomyopathy is a second cause (MI, etc.)

3

short term response to compensate for ↓ CO due to heart failure (LV dysfunction)

Sympathetic discharge⇒ carotid sinus senses the decrease and fires

4

long term compensation for HF

RAAS system⇒ increases Na and H20 reabsorption by the kidneys to increase volume and retain CO

5

what two ways is RAAS activated

1. Sympathetic discharge (carotid sinus)⇒ activation of β1 receptors in kidney = ↑ renin release
2. JG apparatus in kidney ⇒ senses ↓ BP = ↑ renin release

6

How does renin help maintain BV and thus CO

Renin cleaves Angiotensin to Ang I; ACE cleaves Ang I to Ang II⇒ Ang II both vasoconstricts and stimulates aldosterone release from adrenal gland

7

where in adrenal is aldosterone released

zona glomerulosa in adrenal cortex

8

most potent vasoconstrictor in body

Angiotensin II

9

how does ↑ BV help maintain CO

increases preload, which increased SV

10

what are two negative effects that result due to increased BV along with decreased LV function

1. pulmonary edema
2. peripheral edema

11

MCC of right sided HF

left-heart failure

12

signs of right-sided heart failure (3)

1. peripheral edema (pedal, sacral edema)
2. jugular venous distension (JVD)
3. hepatosplenomegaly ⇒ due to IVC backup, causes chronic venous congestion in liver

13

pathology seen in right heart failure

"Nutmeg liver"⇒ due to chronic passive congestion

14

signs of left sided heart failure (4)

1. Dyspnea on exertion
2. Rales
3. Paroxysmal nocturnal dyspnea
4. orthopnea (increase in venous return/ preload when supine exacerbates pulmonary edema)

* these are all due to Pulmonary edema⇒ lung involvement= think LEFT HEART; if right heart fails, you wont even get fluid to the lungs!!

15

characteristic pathology seen in left heart failure

"heart-failure cells"⇒ hemosiderin-laden macrophages in lung

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