Heart Failyre Flashcards
(19 cards)
What’s the most common cause of HF
Ischaemic heart disease
= loss of myocardial function
What is myocarditis
Inflammation of heart muscle after infection
Can rarely cause heart failure from damaging heart
What is cardiac reserve
The difference between maximal cardiac output and cardiac output at rest - can show the hearts ability to increase output when demand is increased
What is preload, how does this compare to afterload?
Preload is the stretch on the heart just before systole (end diastolic ventricular volume) eg: stretched caused when slingshot is pulled back
Afterload is the pressure the heart has to work against - eg: headwind
What is ejection fraction
Stroke volume / end diastolic volume
Measures how well the heart is pumping blood and what proportion of the blood has been ejected from the ventricles in one heartbeat from a specific ventricle - left!!
Normal = 55-70% ejected
HFrEF = 40% - impacted heart pumping
HFpEF = 50% - poor relaxation so cannot fill
What are the 4 main symptoms of heart failure?
- Paroxysmal Nocternal dyspnoea
- orthopnoea
- peripheral oedema
- breathless on exertion
When is pulmonary oedema a symptom of HF
Left HF - back flow of pressure to nearest tissue bed = lungs!!
What is HFrEF
Heart failure with preserved ejection fraction
Usually when heart has problems with relaxing = heart cannot fill properly
Systolic contraction still intact
What is HFrEF
Heart failure with reduced ejection fraction, heart muscle ability to contract is impaired, reduced ejection fraction, heart becomes dialated
What happens when ejection fraction is lost in heart failure
- baroreceptors in carotid/ aortic arch trigger as low pressure coming from hear
- triggers increased sympathetic tone and increases RAAS activation
- encourages overloading/increased fluid volume
- increases myocardial preload and work
What are first line treatments for heart failure
diuretics - decreased FV
Oxygen and ventilation
What diuretics can be given and how/where do they work?
- ferusomide - on LoH
- Thiazide diuretics on DCT
What do ionotropes do? When can they be useful
- affect force of contractility in the heart
- useful when having/getting over heart attack when ischaemia has damaged some myocytes
What must be controlled in HF with treatment to improve prognosis?
SNS Overactivation
RAAS overactivation
What are the 4 pillars of HF treatment
ACE inhibitors/A2RBs
Beta blockers
Mineral corticoid receptor antagonist
SGLT2 inhibitors
