Wk.8 L4 - Heart Failure

Question 1

LO

Answer 1

Heart Failure
* What is Heart Failure
* Types and stages of HF
* Risk factors of HF
* Cardiac Output
* HFpEF and HFrEF
* Complications from HF

Question 2

Classifying Heart Failure

Answer 2

Inability to pump sufficient blood = reduced CO
- Failure to contract (functional)
- Reduced volume of blood leaving (structural)

HF is an end-stage disease state that can
result from numerous CVD

Question 3

Types of HF

Answer 3

Left-sided, right-sided or biventricular

Left-sided HF:
- Impaired systemic perfusion
- Increased pulmonary pressure
- Can lead to biventricular

Right-sided HF:
- Impaired pulmonary perfusion
- Elevated venous pressure

Biventricular HF:
- Both RS-HF and LS-HF

Congestive HF:
- fluid overload
- LS = pulmonary oedema
- RS = peripheral / hepatosplenic oedema

Question 4

Risk Factors for Heart Failure

Answer 4

Linked to Diabetes, CAD and Hypertension
Tobacco and alcohol use
* Obesity and sedentary lifestyle
* Sleep apnoea

Non-modifiable:
* Age and ethnicity
* Familial history of CVD

Question 5

Stages of Heart Failure

Answer 5

Stage A: At risk
- Risk factors without structural/functional changes

Stage B: Pre-Heart Failure
- Structural/functional changes without symptoms
- Breathless walking

Stage C: Heart Failure
- Symptomatic
- Tiredness with simple tasks

Stage D: Advanced Heart Failure
- Symptoms non-responsive to treatment
- Tiredness while sitting

Question 6

Preload and Afterload

Answer 6

Heart Failure: Decreased cardiac output

Preload:
- Extent of ventricular stretch and filling
- Assessed by measuring end-diastolic volume
- Impacted by capacity of blood to enter the ventricle

Afterload
- Pressure needed to eject blood from the heart
- Impacted by aortic and peripheral resistance

Changes to preload or afterload impacts cardiac output

Question 8

HFrEF: Failure to Contract

Heart Failure with reduced ejection fraction

Answer 8

Reduced Ejection Fraction
- Systolic Heart Failure
- Fewer functioning myocytes due to MI, hypertension, dilated cardiomyopathy

Reduced functionality between myocytes= Arrhythmia

Question 9

HFpEF: Reduced Volume

Answer 9

Preserved Ejection Fraction
- Diastolic Heart Failure

Capacity of the heart to fill or relax is reduced
- Increased diastolic pressure
- Reduced ventricular compliance

Increased wall stiffness = restrictive cardiomyopathy

Reduced ventricular filling from:
- Systemic hypertension
- Aortic stenosis
- Hypertrophic cardiomyopathy

Question 10

Complications from Heart Failure

Answer 10

Reduced cardiac output
- Low renal blood flow
- Renin-angiotensin aldosterone system (RAAS)
- Aldosterone and vasopressin (due to RAAS)
- Beta-adrenergic signalling

Increases renal fluid retention → oedema
- Pulmonary oedema (Left-sided) – pulmonary congestion
- Peripheral oedema (Right-sided) – systemic congestion

Stage D: Advanced HF and patient death