heart failure Flashcards Preview

CV exam 1 wk 1 > heart failure > Flashcards

Flashcards in heart failure Deck (31):
1

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 abnormally high (backward failure)

2

HR is a

syndrome describing a constellation of signs and symptoms caused by many possible abnormalities of heart function

3

Poor FORWARD blood flow is a

1. key requirement of HF
2. LOW FLOW (↓ cardiac output)

4

BACKWARD buildup of pressure

1. is almost always present as well
2. CONGESTION (↑ filling pressures)
3. Typically a response to low flow

5

____ determines dysfunction

function

6

dysfunction: Displacement pumps

1. Squeeze (contraction)
2. Fill (relaxation)
3. Failure of either systole or
4. diastole causes HF

7

dysfunction: 2x pumps

left and right in series
Left, right, or both can fail

8

dysfunction: Coordinated by an

1. electrical system
2. Too slow, too fast, asynchronous … all ↓ efficiency

9

dysfunction: Directed by

1. 4x valves
2. Regurgitation (backflow) or stenosis (resistance) stress heart

10

dysfunction: Supplied by

1. coronaries
2. Regurgitation (backflow) or
3. stenosis (resistance) stress heart

11

dysfunction: Encased in

1. pericardium
2. Regurgitation (backflow) or
3. stenosis (resistance) stress heart

12

key mediators of blood flow

1. intropy
2. preload
3. afterload
4. stroke volume
5. heart rate
6. cardiac outpuut

13

Ventricular output increases in relation to

greater filling

14

Inotropy =

contractility

15

The more the LV is filled, the more it

will contract

16

↑ Preload produces

increased SV (and thus CO) for the same inotropic state

17

Same filling (preload) of LV produces a

greater squeeze of contraction

18

Determinants of inotropy

1. Catecholaminergic / adrenergic stimulation
2. Calcium

19

↑ Inotropy produces increased

SV (and thus CO) for the same level of preload

20

↑ Preload cause ___ SV

(↑ SV)

21

↑ Inotropy causes ___ SV

(↑ SV)

22

↑ Afterload causes ___ SV

(↓ SV)

23

Weak / damaged myocardium = ___ failure

systolic

24

Systolic dysfunction

1. problem with squeeze
2. ↓contraction / ↓ inotropy
3. ↓ SV
4. lower generated systolic BP

25

hallmark of systolic dysfunction is

1. Decreased ejection fraction
2. Ventricular enlargement

26

Ventricular enlargement

“dilated cardiomyopathy” = DCM

27

Decreased ejection fraction

1. “HF with reduced ejection fraction” = HFrEF
2. “left ventricular systolic dysfunction” = LVSD

28

Primary causes of systolic HF

1. Direct destruction of heart muscle cells
Myocardial infarction
Viral myocarditis
Peripartum cardiomyopathy
Ideopathic dilated cardiomyopathy
Alcohol
2. Overstressed heart muscle
3. Volume overloaded heart muscle

29

Overstressed heart muscle
can be cause by

1. Tachycardia-mediated HF
2. Methamphetamine abuse
3. Stress-provoked (tako-tsubo cardiomyopathy)

30

Volume overloaded heart muscle can be caused by

1. Mitral regurgitation
2. High cardiac output
3. Shunting of blood
4. Wet beriberi (thiamine B1 deficiency)

31

Direct destruction of heart muscle cells
can be caused by?

1. Myocardial infarction
2. Viral myocarditis
3. Peripartum cardiomyopathy
4. Ideopathic dilated cardiomyopathy
5. Alcohol