Heart Failure – Part I: Pathophysiology Flashcards Preview

zz CVPR > Heart Failure – Part I: Pathophysiology > Flashcards

Flashcards in Heart Failure – Part I: Pathophysiology Deck (26):
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

Poor FORWARD blood flow is a key requirement of HF=

LOW FLOW (↓ cardiac output)

3

BACKWARD buildup of pressure is almost always present as well=

CONGESTION (↑ filling pressures)

Typically a response to low flow

4

Key Mediators of Blood Flow

Intropy
preload
aftload
cardiac output (=SV*HR)

5

Ventricular output increases in relation to ______ filling

greater

6

Heart failure is the inability of the heart to pump blood forward at a sufficient rate to meet the metabolic demands of the body (__________), or the ability to do so only if the cardiac filling pressures are abnormally high (backward failure).”

forward failure

7

Left ventricular end-diastolic pressure (LVEDP) v. stroke volume

Frank-Starling curves

8

↑ Preload produces increased _______ (and thus CO)

↑ Inotropy produces increased _____ (and thus CO)

SV
SV

9

Inotropy =
Determinants are...


=contractility

Catecholaminergic / adrenergic stimulation
Calcium

10

Major Divisions of HF

Systolic
Diastolic
Left side
Right side

11

Decreased ejection fraction
“HF with reduced ejection fraction” = HFrEF

“left ventricular systolic dysfunction” = LVSD

Ventricular enlargement
“dilated cardiomyopathy” = DCM

Characteristics of?

Systolic dysfunction

12

Normal ejection fraction
“HF with preserved ejection fraction” = HFpEF

“preserved systolic function” = PSF

Ventricular wall thickening
“left ventricular hypertrophy” = LVH

Characteristics of?

Diastolic Dysfunction

13

Impaired filling
↓lusitropy / decrease in relaxation

Diastolic Dysfunction

14

A problem with squeeze
↓contraction / ↓ inotropy

Systolic dysfunction

15

Systolic dysfunction Characteristics

Decreased ejection fraction
“HF with reduced ejection fraction” = HFrEF

“left ventricular systolic dysfunction” = LVSD

Ventricular enlargement
“dilated cardiomyopathy” = DCM

16

Primary causes of systolic HF

Direct destruction of heart muscle cells- MI
Overstressed heart muscle
Volume overloaded heart muscle

17

Diastolic dysfunction Characteristics

Normal ejection fraction
“HF with preserved ejection fraction” = HFpEF

“preserved systolic function” = PSF

Ventricular wall thickening
“left ventricular hypertrophy” = LVH

18

Primary causes of diastolic HF

High afterload/pressure overload
Myocardial thickening/fibrosis
External Compression

19

Under normal circumstances the right ventricle pumps the same amount of blood as the left ventricle, but does it against much _____ pressures

lower

20

RV work is much less, and thus a normal RV is a ____ structure

thin walled

21

Stresses to the RV can cause it to fail to adequately pump blood through the lungs, which causes (2)

↓ circulating blood flow (forward RV HF)

↑ venous pressures (backward RV HF)

22

Primary causes of right-sided HF

Left Heart failure
Lung Disease
RV volume overload
Damage to RV myocardium

23

muscular tissue of the heart. Other tissues are the endocardium

myocardium

24

Systolic dysfunction is typically accompanied by ______

diastolic dysfunction (and vice versa)

25

_______ failure often causes RV failure (most common)

LV

26

Neurohormal activation
Frank-Starling (increasing preload)
Ventricular hypertrophy and dilation

Compensatory responses of the heart to HF