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CRP2: KCP1: Breathlessness, cough & haemoptysis > LECTURE: 1.6 Heart Failure & Pulmonary Oedema > Flashcards

LECTURE: 1.6 Heart Failure & Pulmonary Oedema Flashcards

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1
Q

What is another name for heart failure?

A

Congestive heart failure (CHF).

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2
Q

How is the prognosis of heart failure described?

A

It is a progressive condition with a poor prognosis.

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3
Q

At what stage of heart disease does heart failure commonly appear?

A

During the end stage of many forms of chronic heart disease

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4
Q

What is the definition of heart failure (HF) in terms of the heart’s pumping ability?

A

HF is when the heart is unable to pump blood at a rate sufficient to meet the metabolic demands of the tissues or can do so only at an elevated filling pressure.

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5
Q

What causes the clinical syndrome of heart failure?

A

Structural or functional impairment of ventricular filling or ejection of blood.

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6
Q

What are the cardinal clinical symptoms of heart failure?

A

Dyspnoea, fatigue, and signs of HF.

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7
Q

What is ejection fraction (EF)?

A

The amount or percentage of blood that is pumped (or ejected) out of the ventricles with each contraction.

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8
Q

What are the cumulative effects that can lead to heart failure?

A

Chronic work overload, such as in valve disease or hypertension.

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9
Q

How does ischemic heart disease contribute to heart failure?

A

It follows myocardial infarction with extensive heart damage.

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10
Q

What are some examples of acute hemodynamic stresses that can cause sudden CHF?

A
  1. Fluid overload,
  2. acute valvular dysfunction
  3. large myocardial infarction.
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11
Q

What causes HF due to reduced contractility?

A
  1. myocarditis
  2. MI
  3. Cardiomyopathies
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12
Q

What causes pressure overload in HF?

A
  1. HTN
  2. aortic stenosis (LHF)
  3. Pulmonary hypertension
  4. Pulmonary valve stenosis
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13
Q

What causes ventricular inflow obstruction?

A
  1. Mitral Stenosis
  2. tricuspid stenosis
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14
Q

What causes volume overload in HF?

A
  1. VSD
    2.RV overload (ASD)
  2. Increased metabolic demand (high cardiac output)
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15
Q

What arrhythmias can cause HF?

A
  1. Atril fibrilation
  2. tachycardia cardiomyopathy
  3. Complex Heart block
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16
Q

What causes diastolic dysfunction in HF?

A
  1. Constrictive pericarditis
  2. restrictive cardiomyopathy
  3. Ventricular hypertrophy or fibrosis
  4. Cardiac tamponade
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17
Q

What EF value defines heart failure with depressed EF?

A

<40%

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18
Q

What is a coronary artery cause of depressed EF?

A

MI

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19
Q

What are examples of chronic pressure overload?

A
  1. HTN,
  2. obstructive valvular disease
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20
Q

What are causes of chronic volume overload?

A
  1. Regurgitant valvular disease,
  2. left-to-right shunt
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21
Q

What chronic lung diseases can cause depressed EF?

A
  1. Cor pulmonale,
  2. pulmonary vascular disease
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22
Q

What are types of non-ischemic dilated cardiomyopathy?

A
  1. Genetic disorder
  2. infiltrative disorder
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23
Q

What causes toxic or drug-induced heart failure?

A
  1. Metabolic disorder
  2. viral damage
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24
Q

What rhythm disorders can cause depressed EF?

A
  1. Chronic bradyarrhythmias
  2. tachyarrhythmias
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25
What parasitic disease can cause HF with depressed EF?
Chagas disease
26
What EF range defines heart failure with preserved EF?
>40–50%
27
What type of hypertrophy is linked to preserved EF?
Pathologic hypertrophy
28
What causes pathologic hypertrophy in HFpEF?
1. Hypertrophic cardiomyopathies 2. secondary to HT
29
How does aging contribute to HFpEF?
Age-related myocardial stiffening
30
What are causes of restrictive cardiomyopathy?
1. Infiltrative (amyloidosis, sarcoidosis), 2. storage (hemochromatosis)
31
What structural changes contribute to HFpEF?
1. Fibrosis 2. endomyocardial disorders
32
What metabolic disorder causes high-output HF?
Thyrotoxicosis
33
What nutritional disorder is linked to high-output HF?
Beriberi
34
What vascular condition increases blood flow demand in high-output HF?
Systemic arteriovenous shunting
35
What blood condition can lead to high-output HF?
Chronic anaemia
36
What are causes of low output heart failure?
1. IHD 2. dilated cardiomyopathy 3. HTN 4. Valvular & Pericardial diseases
37
What are causes of high output heart failure?
1. Hyperthyroidism 2. anaemia 3. pregnancy 4. AV fistula 5. beri beri 6. Paget’s disease of bone
38
What are common causes of left-sided heart failure?
1. Systemic HTN 2. mitral/aortic valve stenosis 3. IHD 4. primary myocardial diseases
39
What are common causes of right-sided heart failure?
1. LVF 2. cor pulmonale 3. tricuspid/pulmonic valve disease 4. left-to-right shunt
40
What three factors determine cardiac output (CO) in Starling’s law?
1. Preload 2. afterload 3. myocardial contractility
41
What is preload?
Volume & pressure of blood in ventricle at end of diastole
42
What is afterload?
Volume & pressure of blood in ventricle during systole (stroke volume)
43
What is the relationship between stroke volume and end-diastolic volume?
Direct relationship: ↑ EDV → ↑ stroke volume
44
How does increased preload affect the heart?
Increases contraction and myocardial stretch, raising stroke volume
45
Why does stroke volume increase with preload in HF?
To maintain cardiac output (CO)
46
What does the Frank-Starling mechanism do in HF?
↑ Filling volume dilates heart, ↑ contractility & stroke volume
47
What are myocardial adaptations in HF?
Ventricular hypertrophy with/without chamber dilation
48
What systems are activated as part of neurohumoral compensation in HF?
1. Autonomic NS 2. RAA system 3. ANP release
49
What does norepinephrine do in HF compensation?
- ↑ HR - ↑ contractility - ↑ vascular resistance (vasoconstriction)
50
What hormone system increases fluid retention in HF?
Renin-Angiotensin-Aldosterone (RAA) system
51
What peptide is released in response to atrial stretch in HF?
Atrial natriuretic peptide (ANP)
52
What initiates the vicious cycle in progressive HF?
- Myocyte loss - myocardial fibrosis
53
What does myocyte loss lead to?
Heart failure with reduced cardiac output
54
What systems are activated during neurohumoral activation in HF?
- SNS - RAAS - vasopressin system - endothelin system
55
What does neurohumoral activation cause?
- Vasoconstriction - sodium/water retention
56
What does vasoconstriction lead to?
Increased afterload
57
What does sodium and water retention lead to?
Increased intravascular volume
58
What do both afterload and volume overload cause?
- Increased BP - cardiac work
59
How does increased BP and workload affect the heart?
Worsens myocyte loss, continuing the cycle
60
Can adaptive mechanisms always maintain cardiac output in HF?
No, they may be overwhelmed over time.
61
What causes systolic dysfunction in HF?
Progressive deterioration of myocardial contractile function.
62
What causes diastolic dysfunction in HF?
Inability of the heart chamber to expand and fill during diastole.
63
What are examples of conditions leading to diastolic dysfunction?
1. Massive LV hypertrophy 2. myocardial fibrosis 3. amyloid deposition 4. constrictive pericarditis.
64
What triggers cardiac hypertrophy?
↑ Mechanical workload (pressure or volume)
65
What happens to the heart during myocyte hypertrophy?
↑ Size and weight of the heart
66
What is pressure-overload hypertrophy?
Concentric wall thickening from sarcomeres added in parallel
67
What is volume-overload hypertrophy?
Ventricular dilation from sarcomeres added in series

CRP2: KCP1: Breathlessness, cough & haemoptysis (1 decks)

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