Lecture 18

Question 1

classifying heart failure

Answer 1

Inability of heart to pump and sufficient blood (decreases CO) due to decrease ability to contract (functional) or decreased volume of blood leaving (structural in response to functional issue). End-stage disease state arising from numerous disease states.

Question 2

LS heart failure

Answer 2

insufficient blood leaving LV, impairing systemic perfusion. As lack of blood leaves LV, it backs up behind the LV in LA i.e in lungs, increases pulmonary pressure.

Question 3

RS heart failure

Answer 3

Not enough blood pumped from LV impairing pulmonary perfusion where blood backup in RA increasing venous pressure.

Question 4

Biventricular Heart failure

Answer 4

RH and LH

Question 5

congestive heart failure

Answer 5

Fluid overload. LHS -> pulmonary oedema. RHS to peripheral oedema or hepatosplenic.

Question 6

Risk factors of HF

Answer 6

~480,000 Australians. Risk factors reflect disease states.

Question 7

Stage A

Answer 7

Breathlessness when jogging (exertion). Risk factors without structural/functional changes

Question 8

Stage B

Answer 8

Structural or functional changes with minimal symptoms like breathlessness while walking

Question 9

Stage C

Answer 9

Symptomatic. Tired with everyday tasks

Question 10

Stage D

Answer 10

Symptoms not responsive to treatment. Tiredness while sitting.

Question 11

Preload

Answer 11

Extent of ventricular stretch and filling occurring during diastole. Assessed by measuring end diastolic volume. Frank-Starling Law. Impacted by capacity of blood to enter ventricle.

Question 12

Afterload

Answer 12

Amount of pressure/resistance the ventricles need to overcome during systole for it to enter circulation. Impacted by aortic and peripheral resistance.

Question 13

Ejection fraction

Answer 13

= SV/total volume. measures changes in CO

Question 14

Changes in Ejection fraction

Answer 14

Failure to contract=decrease stroke volume = decrease ejection fraction.

decrease volume = decrease stroke volume and TV = same EF

healthy is 50-70%

Question 15

HFrEF (failure to contract)

Answer 15

decrease EF, systolic HF. The contractile capacity decreases as they have fewer functioning myocytes due to MI. Scar tissue cannot contract. Hypertrophy of LV due to hypertension increases demand of O2. Dilated cardiomyopathy = thinner and weaker LV wall due to decrease myocardial mass. Also decreases functioning of myocytes due to arrhythmia

Question 16

HFpEF: volume decrease

Answer 16

Decrease volume existing in LV and being ejected. Diastolic heart failure. increases diastolic pressure or decreases ventricular filling = decreasing ventricular compliance. Occurs due to increasing wall stiffening from restrictive cardiomyopathy or decrease ventricular filling due to systemic hypertension (hypertrophy of LV walls to overcome higher peripheral resistance and increase afterload; aortic stenosis and hypertrophic cardiomyopathy.

Question 17

complications of heart failure

Answer 17

breathlessness = lack of O2 circulating

decrease CO = decrease blood volume, decrease renal blood flow = activation of renin-angiotensinogen aldosterone system.

Increase renal fluid retention = oedema

Backwood failure: LHS HF = pulmonary congestion (dyspnoea and orthopnoea)

RHS HF = systemic congestion (skin pitting and jaundice)