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Cards In This Set
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What is heart failure?
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Heart is unable to pump sufficient blood flow to meet the requirements of the tissues
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Describe the NYHF classification of HF
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Class I: no limitationClass II: dyspnoea and fatigue with moderate activity (e.g. walking up stairs quickly)Class III: marked limitation - dyspnoea with minimal activity (e.g. slowly walking up stairs)Class IV: severe limitation + symptoms at rest
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Causes of Heart Failure
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- IHD (75%)- cardiomyopathy - 2nd most common- congenital heart disease- valvular heart disease- Hypertensive heart disease
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Precipitating causes of heart failure
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- High CO states (pregnancy and thyrotoxicosis)- Hypertension aggravation- Excess (fluid, dietary, emotional, environmental etc)- MI- Infection (pulmonary)- Arrythmia *** (most frequent)- Myocarditis - Infective endocarditis- PE- Anaemia (need inc CO)
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Name 4 causes of dilated cardiomyopathy
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Alcoholmetabolic (hyper/hypothyroid)myocarditishereditary defects in myocardial metabolismhaemochromatosisdrugs/heavy metal poisoning
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What causes restrictive cardiomyopathy?
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Amyloidosis
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Name 4 consequences of reduced CO
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Effort intolerance, fatigue, cognitive impairment, sleep disturbance, renal impairment, hepatic impairment
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Name 4 consequences of venous congestion (HF)
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Peripheral oedemaOrthopnea,sleep disturbanceGIT symptoms
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T/F chronic hypertension will cause eccentric hypertrophy
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FALSE - increased systolic pressure causes parallel addition of myofibrils and concentric hypertrophy
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What are the two main causes of systolic heart failure
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1. increased afterload (AS/HTN)2. impaired contractility (MI, chronic volume overload in MR/AR), dilated cardiomyopathy
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What are the two main causes of diastolic failure
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1. Impaired ventricular relaxation (LV hypertrophy, HOCM, restrictive cardiomyopathy, transient MI)2. Obstruction to LV filling (MS, pericardial constriction/tamponade)
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Will mitral stenosis cause systolic or diastolic failure?
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Diastolic
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Will chronic aortic stenosis lead to systolic or diastolic heart failure?
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Systolic (increased afterload)
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Describe low output heart failure
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HF where CO is reduced (may be normal at rest but fails to rise normally with exertion)
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Name 4 causes of low output heart failure
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MI, dilated cardiomyopathy, valvular and pericardial disease
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