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19 Cards in this Set

  • Front
  • Back
What is the definition of heart failure?
Inability of heart to pump blood forward fast enough to meet metaboic demands (forward failure) or only being able to meet demands if pressures abnormally high (backwards failure)
What are two types of heart failure?
Forward heart failure
Backward heart failure
What are principal functional classes of heart failure? (3)
Heart failure with reduced ejection fraction (dilated heart)
Heart failure with preserved ejection fraction (stiff heart)
Right heart failure
True or false - heart failure is a clinical syndrome with multiple possible causes
True
What are the 2 main categories of causes of heart failure?
1. Primary cardiomyopathies
2. Secondary cardiomyopathies
What types of primary cardiomyopathies can cause heart failure? (3)
1) Genetic - HCM, ARVD, etc.
2) Mixed - DCM, etc.
3) Acquired - myocarditis, etc.
What are classical structural forms for cardiomyopathic disease? (1)
1) dilated cardiomyopathy - big chamber, normal/thin wall
2) hypertrophic cardiomyopathy - Thick wall small chamber
3) restrictive cardiomyopathy - small chamber normal wall
What type(s) of heart failure is/are seen with dilated cardiomyopathy?
typically forward, but can have +/- backward
What causes dilated cardiomyopathy (primary or secondary process)?
both
What are classic histological findings for dilated cardiomyopathy and are they specific?
hypertrophy, fibrosis, degeneration of cardiomyocytes - usually not specific but some causes can be (amyloidosis (amyloid), hemochromatosis (iron), myocarditis (lymphocytes)
What are patterns of hypertrophic cardiomyopathy and what is the most common?
Assymetric septal hypertrophy (most common)
Concentric hypertrophy
Apical hypertrophy
What is a SAM lesion and what is the pathophysiology of it?
Systolic anterio motion - means the mitral valve cusp is pushed anteriorly during systole which blocks the LV outflow tract and causes blood to leak back into the atrium
What is a specific histological characterstic hypertrophic cardiomyopathy?
Myofibredissarray
What diseases can cause hypertophy of the heart but are not hypertrophic cardiomyopathies?
Fabry's Disease, acromegaly, hypertensive heart disease
What diseases can cause restrictive cardiomyopathy?
Sarcoidosis
Idiopathic restrictive cardiomyopathy
What are typical pathologies of heart muscle in restrictive cardiomyopathy? (2)
Infiltration and fibrosis
What is the sequence of events that leads to cardiomyopathy with preserved ejection fraction?
Diastolic (relaxation) dysfunction -> increased LV stiffness -> atrial dysfunction -> decompensation and/or sudden death and/or DCM
What is arrhythmogenic right ventricular cardiomyopathy?
Fibrofatty replacement of myocardium in the anterior wall of the right ventricle
What can cause right heart failure? (3)
Pulmonary hypertension
Pulmonary disease
Left to right shunts