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Flashcards in Session 11 Deck (28)
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1

Define heart failure

a state in which the heart fails to maintain an adequate circulation for the needs of the body despite an adequate filling pressure

2

What is the primary cause of Systolic heart failure?

Ischaemic heart disease

3

What are some of the other causes of Heart failure?

Hypertension
Dilated cardiomyopathy (Microbes/drugs)
Valvular heart disease
Arrhythmia

4

How is Starling's law related to Heart failure?

Heart can no longer produce the same force or cardiac output for a given filling pressure

5

What is Class I heart failure?

No symptomatic limitation of physical activity

6

What is Class II heart failure?

Slight limitation of physical activity
No symptoms at rest

7

What is Class III heart failure?

Limited physical activity
No symptoms at rest

8

What is Class IV heart failure?

Cannot carry out physical activity
Symptoms at rest
Discomfort increases with any physical activity

9

What is congestive heart disease?

Where the ventricles on both sides of the heart fail.

10

Which side of the heart rarely fails in isolation?

The right side. It is usually the left which then causes right side as well

11

What are the 5 types of heart failure?

Left sided
Right sided
Biventricular 9congestive)
Systolic
Diastolic

12

What are some of the symptoms of left sided heart failure?

Fatigue
Shortness of Breath
Tachycardia
Basal pulmonary crackles
Pulmonary oedema

13

What are some of the causes of Right sided heart failure?

Secondary to heart failure
Chronic lung disease
PE
Valvular disease (Tricuspid/pulmonary)
Left to right shunts

14

What are some of the symptoms of right sided heart failure?

Peripheral oedema
Fatigue
Nausea
Raised JVP
Hepatic enlargement

15

Why is the Renin Angiotensin Aldosterone System (RAAS) activated in heart failure?

To maintain cardiac output
They make a struggling heart work harder

16

What stimulates Renin release form the Kidneys?

A drop in blood pressure

17

What does Renin do?

Catalyses the reaction of Angiotensin to Angiogtensin I

18

What does ACE do?

Convert Angiotensin I to Angiotensin II

19

What does Angiotensin II do?

It is a powerful vasoconstrictor so causes aldosterone to be released from the Kidneys

20

What does Aldosterone do?

Retains Na+ and H2O so increases blood volume

21

How does the Sympathetic nervous system effect the Heart and vessels?

Vasocontictor on blood vessels acting via alpha 1 receptors
Increases Chronotrophy and Inotrophy using beta 1 receptors

22

Why are ACE inhibitors used in heart failure?

They prevent the conversion of Angiotensin I to Angiotensin II
So indirect diuretic and vasodilator effect

23

Why are Beta blockers used in heart failure?

Prevent sympathetic innervation of the myocardium

24

What are the principles in treating heart failure?

Correct the underlying cause
Lifestyle changes
Pharmacological (Improve symptoms, delay progression, reduce mortality)
Treat complications

25

What are the 5 groups of drugs used to treat heart failure?

Beta blockers
ACE inhibitors
Ca2+ channel blockers
Organic nitrates
Cardiac Glycosides

26

How do Ca2+ channel blockers help in treatment of heart failure?

They reduce the contractility of the myocardium

27

How do Organic nitrates help in treatment of heart failure?

Dilatory effect so blood pressure reduces

28

How do Cardiac Glycosides help in treatment of heart failure?

They increase the cardiac output and contractility
Inhibit Na+/K+ pump, raised Na+, NCX inhibited, Ca2+ increases, increased contractility