Heart Failure

Preload refers to the initial stretching of the heart muscles prior to contraction, while afterload is the amount of resistance the heart must overcome to eject blood out into the circulatory system.

Heart failure is a condition in which the heart cannot pump enough blood to meet the body's needs. Cardiac Arrest is a sudden loss of heart function, breathing, and consciousness and is not the same as heart failure. Arrhythmia refers to an irregular heartbeat, but it is not the same as heart failure. Hypertension is high blood pressure and although it can lead to heart failure if left untreated, it is not the same as heart failure.

Heart failure is commonly associated with various cardiac and vascular conditions, as listed in the correct answer options. Conditions like type 2 diabetes, asthma, and osteoarthritis are not direct risk factors for heart failure.

Symptoms like restlessness, confusion, and orthopnea are commonly associated with left sided heart failure due to the buildup of fluid in the lungs, leading to difficulty breathing when lying flat (orthopnea) and reduced oxygen levels causing restlessness and confusion.

In right sided heart failure, the increased pressure in the right side of the heart leads to systemic venous congestion, which manifests as increased peripheral venous pressure and fluid accumulation in the abdomen (ascites).

In right-sided heart failure, the impaired pumping of the heart causes blood to back up in the venous system leading to symptoms such as an enlarged liver and spleen, distended jugular veins, and fluid retention.

Left sided heart failure leads to congestion in the lungs, causing symptoms such as cough, crackles, wheezes, blood tinged sputum, and tachypnea.

Left sided heart failure is commonly associated with symptoms such as tachycardia (increased heart rate), exertional dyspnea (shortness of breath with physical activity), and cyanosis (bluish discoloration of the skin due to lack of oxygen). These symptoms are often indicative of impaired function of the left side of the heart.

Right sided heart failure may be secondary to chronic pulmonary problems due to increased pressure in the pulmonary circulation leading to right ventricular strain and eventual failure.

Paroxysmal nocturnal dyspnea and elevated pulmonary capillary wedge pressure are classic signs of left-sided heart failure, commonly due to fluid buildup in the lungs resulting from the inability of the left ventricle to adequately pump blood forward.

In right sided heart failure, anorexia and complaints of GI distress are commonly observed due to congestion in the systemic circulation resulting in abdominal symptoms.

In heart failure, right-sided heart failure is commonly associated with symptoms such as weight gain and dependent edema due to the backed up blood flow affecting the systemic circulation.

Systolic failure is the most prevalent cause of heart failure where the heart's pumping function is compromised. While conditions like hypertension, valvular heart disease, and cardiomyopathy can contribute to heart failure, they are not the most common cause.

Systolic heart failure is characterized by a decrease in the left ventricular ejection fraction (EF). This occurs due to impaired contractile function, increased afterload, cardiomyopathy, and mechanical abnormalities like valve disease.

Ejection fraction specifically refers to the percentage of blood that is pumped out of the left ventricle with each heartbeat, not the volume of blood in the ventricle, heart rate during systole, or thickness of the myocardium.

Ejection fraction is a measurement used to determine how well your heart is pumping out blood. Normal ejection fraction ranges from 50-70%. An ejection fraction of 36-49% is considered below normal, while an ejection fraction of 35-40% may confirm the diagnosis of systolic heart failure.

An ejection fraction (EF) of less than 35% indicates a weakened heart muscle, which can lead to life-threatening irregular heartbeats.

An ejection fraction (EF) of 35-40% may confirm a diagnosis of systolic heart failure, as it indicates reduced ability of the heart to pump blood out to the body. It is important to note that someone with diastolic heart failure can have a normal EF, as diastolic heart failure is characterized by the heart's inability to relax and fill properly.

Diastolic failure refers to the ventricles' inability to relax and fill properly during diastole, impacting stroke volume and cardiac output.

In heart failure, the body compensates by activating the sympathetic nervous system (SNS) to increase heart rate and contractility. This helps maintain cardiac output in the face of reduced cardiac function.

In heart failure, the sympathetic nervous system (SNS) responds by releasing catecholamines, increasing heart rate, myocardial contractility, and causing peripheral vasoconstriction to compensate for the weakened heart function.

In heart failure, compensatory mechanisms such as the renin-angiotensin-aldosterone system are activated to help maintain blood pressure and perfusion to vital organs.

Angiotensin II primarily causes vasoconstriction and stimulates the release of aldosterone, leading to increased blood pressure and fluid retention.

In heart failure, the compensatory mechanism of neurohormonal responses aims to maintain adequate perfusion to vital organs. The secretion of antidiuretic hormone (ADH) by the pituitary in response to low cardiac output (CO) helps in water retention to support blood pressure. The incorrect answers do not align with the specific compensatory mechanism described in the question.

Compensatory mechanisms in response to physiological stress or injury often lead to hypertrophy of tissues and the release of natriuretic peptides to regulate fluid balance and blood pressure.

Hypertrophy refers to the increase in muscle mass and cardiac wall thickness as a response to chronic dilation, usually caused by strength training or cardiovascular exercise.

Natriuretic peptides are hormones that play a key role in regulating fluid and salt balance in the body. The correct answer options, atrial natriuretic peptide (ANP) and B-type natriuretic peptide, are specific types of natriuretic peptides produced by the heart in response to changes in blood volume and pressure.

Natriuretic peptides are hormones released in response to increases in atrial volume and ventricular pressure. They promote venous and arterial vasodilation, reducing preload and afterload.

BNP levels below 100 pg/mL generally indicate the absence of heart failure. Mild, moderate, and severe heart failure would typically present with higher BNP levels.