Hypertensive Heart Disease

Question 1

Pathogenesis

Answer 1

• -causes increased afterload

- -LV compensates w/ concentric hypertrophy until it can’t compensate anymore

Question 2

Most common cause of HF w/ preserved ejection fraction

Answer 2

COMPENSATED Hypertension

Question 3

Decompensated Hypertensive Heart Disease is typically associated w/…

Answer 3

impiared left ventricular filling…diastolic dysfunction

myocardial fibrosis
decreased compliance
restrictive cardiomyopathy

Question 4

Symptoms of HF due to HTN Heart disease

Answer 4

same as those from any other systolic dysfunction pump failure

Question 5

Signs of HF due to HTN Heart disease

Answer 5

subtle difference from other causes of HF…

S4 gallop

Question 6

What does S4 gallop sound like?

Answer 6

“Tennessee”

Question 7

What causes S4?

Answer 7

vigorous LA contraction required to inject blood into stiffened LV

“atrial gallop”

Question 8

Is S4 always pahtologic?

Answer 8

No.

Young people can have sometimes

Question 9

Summation gallop

Answer 9

Some pts have if they have both S3 and S4 w/ tachycardia (shortened diastole),,, the sounds overlap

Question 10

How to distinguish b/w HF due to diastolic dysfunction and HF due to systolic dysfunction

Answer 10

echocardiography

Question 11

Therapies helpful for systolic HF treatment but NOT for diastolic HF treatment

Answer 11

beta-blockers
ACEIs
ARBs
inotropic agents