Flashcards in heart failure Deck (31)
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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)
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↑ Inotropy causes ___ SV
(↑ SV)
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↑ 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
