Flashcards in Heart Failure Deck (46)
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
What is the primary cause of systolic heart failure?
Ischaemic heart disease
Other than IHD, what are the causes of HF?
Valvular heart disease
High-output heart failure
What can cause dilated cardiomyopathy?
What can cause restrictive cardiomyopathy?
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)
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
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
What are the types of heart failure?
What will be seen in class I heart failure?
No symptomatic limitation of physical activity
What will be seen in class II heart failure?
Slight limitation of physical activity
Ordinary physical activity results in symptoms
No symptoms at rest
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
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
Does heart failure affect one or both sides of the heart?
Can be either
Does right-sided heart failure occur on its own?
When may right sided heart failure occur on its own?
In the case of chronic lung disease
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
What is it called when both ventricles are affected in heart failure?
Congestive heart failure
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
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
3rd or 4th heart sound
Functional murmur of mitral regurgitation
Basal pulmonary crackles
What is cardiomegaly?
Displaced apex beat
What is it called when there is a 3rd or 4th heart sound?
When is right sided heart failure most common?
Secondary to left heart failure
What can cause right sided heart failure?
Chronic lung disease
Pulmonary/tricuspid valvular disease
Left to right shunts (ASD/VSD)
Isolated right ventricular cardiomyopathy
What are the symptoms of right sided heart failure?
Distension and fluid accumulation (peripheral oedema) in areas drained by systemic veins
Tendor, smooth hepatic enlargement
Dependent pitting oedema
What is activated in heart failure?
The renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system
Why are the sympathetic nervous system and RAAS activated in heart failure?
In an attempt to maintain cardiac output
What effect does the activation of the sympathetic nervous system and RAAS have?
Making an already struggling heart work harder
What does a drop in blood pressure, such as in heart failure, stimulate?
Renin release from the kidneys