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Flashcards in Norton - HF Deck (34):
1

Obstruction of flow leads to increase in _____

afterload

2

regurgitant flow leads to increase in

preload

3

Frank starling mechanism

increased preload causes dilation and increased contractility

4

Neurohumoral system activation as part of heart compensation

NE
RAA system
ANP

5

What precedes heart failure?

Hypertrophy

6

Causes for cardiac hypertrophy

increased mechanical workload
Trophic signals

7

How does hypertrophy occur

protein synthesis is stimulated -- more sarcomeres

8

What are two patterns of hypertrophy

Concentric - pressure overload
Volume overload

9

Increased cavity diameter is seen in

Volume overload hypertrophy

10

New sarcomeres in concentric vs volume hypertrophy

Concentric - parallel
Volume - in series with existing

11

In volume overload, wall thickness is ____ whereas in in concentric, it is ______

Volume - varies
Concentric - increased thickness

12

_______ hypertrophy is risk factor for sudden death

LV

13

What is a key issue with cardiac hypertrophy

No inc in # of capillary with increased size of myocytes. BUT they require more oxygen/nutrients (Mitochondria)

14

S wave in LVH

greater than 30 mm in V2 and V3

15

physiologic hypertrophy is different in that capillaries

increase in density

16

what type of hypertrophy does aerobic exercise cause

Volume-load type

17

what type of hypertrophy does static exercise cause

Pressure type

18

cause for concentric hypertrophy

hypertension
aortic stenosis

19

cause for volume hypertrophy

mitral or aortic valve regurgitation

20

Changes occur _____ to heart

distant

21

forward failure

poor perfusion

22

backward failure

pulmonary, peripheral edema

23

CV system is a ____ circuit

closed

hence L-sided failure -- > R-sided failure

24

Most patients present with clinical syndromes of _____

both R-sided/L-sided HF

25

Causes - L-sided HF

IHD
Htn
Aortic/mitral valvular disease
Nonischemic myocardial dz

26

Result of L-sided HF

congestion w/in pulm circ
dec periph BF

27

CHF is most often due to

Systolic dysfunction (contractile)

28

Systolic dysfunction

insufficient CO, dec EF

29

what other cardiac dysf show systolic dysf

IHD
Htn
Dilated cardiomyopathy

30

Diastolic dysf

failure to relax, expand, fill

dec SV, can't respond to increased demand

31

what other cardiac issues show diastolic dysf

Massive LVH
myocardial fibrosis
Constrictive pericarditis

32

most common cause for R-sided HF

Left-sided HF

33

Cor pulmonale

pure right-sided failure

Due to parenchymal dz of lungs OR disorder of pulm vasculature

34

Disorders of pulmonary vasculature

Primary pulm htn, recurrent pulm embolus, dz causing hypoxia (Obs sleep apnea, altitude sickness)