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