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ESA 2- Cardiovascular System > Heart Failure > Flashcards

Flashcards in Heart Failure Deck (46)
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1

What is heart failure defined as?

A state in which the heart fails to maintain an adequate circulation for the needs of the body despite an adequate filling pressure

2

What is the primary cause of systolic heart failure?

Ischaemic heart disease

3

Other than IHD, what are the causes of HF?

Hypertension
Dilated cardiomyopathy
Valvular heart disease
Restrictive cardiomyopathy
Hypertrophic cardiomyopathy
Pericardial disease
High-output heart failure
Arrythmia

4

What can cause dilated cardiomyopathy?

Bugs
Alcohol
Drugs
Poisioning
Pregnancy

5

What can cause restrictive cardiomyopathy?

Amyloidosis

6

What does the force developed in the myocardium depend on?

The degree to which the fibres are stretched (or how much the heart is filled)

7

What happens to the force developed in the myocardium in heart failure?

The heart can no longer produce the same amount of force (or cardiac output) for a given level of filling

8

What will be seen on the Starlings Law of the Heart Curve with heart failure?

In mild failure, will be less cardiac output for the same filling
In gross failure, after a point, increasing filling will result in reduced cardiac output

9

What are the types of heart failure?

Class I
Class II
Class III
Class IV

10

What will be seen in class I heart failure?

No symptomatic limitation of physical activity

11

What will be seen in class II heart failure?

Slight limitation of physical activity
Ordinary physical activity results in symptoms
No symptoms at rest

12

What will be seen in class III heart failure?

Marked limitation of physical activity
Less than ordinary physical activity results in symptoms
No symptoms at rest

13

What will be seen in class IV heart failure?

Inability to carry out physical activity without symptoms
May have symptoms at rest
Discomfort increases with any degree of physical activity

14

Does heart failure affect one or both sides of the heart?

Can be either

15

Does right-sided heart failure occur on its own?

Rarely

16

When may right sided heart failure occur on its own?

In the case of chronic lung disease

17

What is the most common scenario in heart failure?

Left-sided heart failure that raises pulmonary arterial pressure, leading to additional right sided heart failure

18

What is it called when both ventricles are affected in heart failure?

Congestive heart failure

19

What is heart failure often divided to in clinical practice?

Left sided heart failure
Right sided heart failure
Biventricular (congestive) heart failure
Systolic heart failure
Diastolic heart failure

20

What are the symptoms of left sided heart failure?

Fatigue, shortness of breath upon exertion or when lying lat, waking from sleep with shortness of breath
Tachycardia
Cardiomegaly
3rd or 4th heart sound
Functional murmur of mitral regurgitation
Basal pulmonary crackles
Peripheral oedema

21

What is cardiomegaly?

Displaced apex beat

22

What is it called when there is a 3rd or 4th heart sound?

Gallop rhythm

23

When is right sided heart failure most common?

Secondary to left heart failure

24

What can cause right sided heart failure?

Chronic lung disease
Pulmonary embolism/hypertension
Pulmonary/tricuspid valvular disease
Left to right shunts (ASD/VSD)
Isolated right ventricular cardiomyopathy

25

What are the symptoms of right sided heart failure?

Distension and fluid accumulation (peripheral oedema) in areas drained by systemic veins
Fatigue
Dyspnoea
Anorexia
Nausea
Raised JVP
Tendor, smooth hepatic enlargement
Dependent pitting oedema
Ascities
Pleural effusion

26

What is activated in heart failure?

The renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system

27

Why are the sympathetic nervous system and RAAS activated in heart failure?

In an attempt to maintain cardiac output

28

What effect does the activation of the sympathetic nervous system and RAAS have?

Making an already struggling heart work harder

29

What does a drop in blood pressure, such as in heart failure, stimulate?

Renin release from the kidneys

30

What is renin?

An enzyme which catalyses the conversion of angiotensin to angiotensin I