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17 Cards in this Set
- Front
- Back
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Causes of Left Heart Failure
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IHD
Systemic HTN Mitral or Aortic valve disease Primary diseases of myocardium |
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Causes of Right Heart Failure
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LHV
Cor Pulmonale Pulmonary or Tricuspid valve disease |
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Compensatory Mechanisms in LHF
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Renin-angiotensin-aldosterone (RAA)
ANP Norepinephrine form SANS |
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Why are patients with LHF asymptomatic for years?
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B/c compensatory mechanisms kick in to modulate LV function within a physiologic/homeostatic range, such that the functional capacity of the patient is preserved or is depressed only minimally.
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What causes the switch from asymptomatic to symptomatic HF?
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Ventricular remodeling
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Why does ischemia cause diastolic dysfunction?
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ATP is required for muscle relaxation.
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Causes of diastolic dysfunction and increased end-diastolic pressure?
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Ischemia
Reduced ventricular compliance (hypertrophy, fibrosis...) Increased heart rate |
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Changes associated with ventricular remodeling
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1. Hypertrophy
2. Alterations in contractile properties of myocytes 3. Necrosis/apoptosis/autophagic cell death of myocytes 4. Beta-adrenergic desensitization 5. Abnormal myocardial energetics and metabolism 6. Reorganization of extracellular matrix |
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What causes ventricular remodeling?
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Sustained overactvity of:
1. Mechanical stretch 2. Circulating hormones 3. Inflammatory cytokines 4. Growth factors 5. ROS |
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Ventricular remodeling is represented as what?
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Changes in:
1. Mass 2. Volume 3. Shape (Ellipsoid vs. Spherical and Thinned vs. Hypertrophied) 4. Composition of the heart |
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Symptoms of LHF
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Orthopnia
Paroxysmal Nocturnal Dyspnia Pulmonary Edema Cardiomegaly Tachycardia S3 Fine Rales Mitral regurgitation/Systolic Murmur (Due to dilation of LV) Cheyne-Stokes Respirations |
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Symptoms of RHF
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Systemic venous congestion (ex. pedal edema)/anasarca
Portal congestion (ex. nutmeg liver/congestive splenomegaly) Pleural effusion Ascites |
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Nutmeg liver is/is caused by?
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Congested red centers of liver lobules surrounded by paler/fatty periphery.
Congestive hepatomegaly. Caused by hepatic congestion, caused by RHF. |
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Centrilobular necrosis of the liver is caused by?
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Central hypoxia due to portal congestion caused by RHF with LHF
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Pulmonary edema is caused by?....As opposed to Pleural effusion is caused by?
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Pulmonary edema - LHF
Pleural Effusion - RHF or LHF |
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Is the edema caused by HF exudative or transudative?
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Transudate
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Anasarca is?
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Generalized massive edem.
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