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Flashcards in Heart Failure Deck (19)
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1
Q

Define heart failure

A

Failure of heart to supply oxygen to periphery

2
Q

What are the underlying problems of heart failure?

A

Left ventricular dysfunction

Neuroendocrine activation

3
Q

True/False? The pathology of Congestive heart failure is complex

A

True

4
Q

What are the Four classes of congestive heart failure?

A

Class I:
Failure associated with no limitations on ordinary activities and activities, but revealed during exercise

Class II:
Slight limitation on ordinary activity resulting in fatigue/palpitations

Class III:
No symptoms at rest but fatigue etc with less than ordinary physical activity

Class IV:
Associated with symptoms even at rest

5
Q

What are the three immediate effects of congestive heart failure?

A

Reduced cardiac output
Excessive sympathetic discharge
Salt/water retention

6
Q

What are the three long term effects of congestive heart failure?

A

Remodeling (of vascularization)
Cardiac Hypertrophy
Cardiac apoptosis

7
Q

What is preload / afterload?

A

Preload: Atrial pressure (diastolic pressure)
Afterload: Vascular resistance (systolic pressure)

8
Q

What are the four factors that affect cardiac output and how are they altered?

A

Preload: increased by increased blood volume/venous tone

Afterload: increased due to reflex sympathetic outflow/RAAS

Contractility: reduction in pump performance

Heart Rate: Increases through sympathetic NS compensation

9
Q

Normally an increase in preload would show a(n) _______ in ventricular performance, but in the case of congestive heart failure the slope is _______

A

increase

decreased (still positive)

10
Q

What is a compensatory response to congestive heart failure?

A

Kidney thinks body is hypotensive and RAAS kicks in

11
Q

Name a positive inotropic drug class and a drug in that class, it’s mechanism, and possible side effects

A

Cardiac glycosides (Digoxin)

Block Na/K ATPase
Cardiac parasympathetic effect
-Slows heart rate AND increases contractile force

  • v. toxic
  • causes arrhythmias
  • upsets GI
  • Neuroendocrine effects (rare)
12
Q

True/False? Positive inotropic drugs are the first line again congestive heart failure

A

False, used as last resort

13
Q

Name a diuretic, describe its mechanism and potential side effect

A

Furosemide

Lowers blood volume

  • hypokalemia
14
Q

Name two types of angiotensin antagonists, and an example of each. Describe their mechanisms and potential side effects

A

ACE inhibitors (Captopril):
Reduces Angiotensin II synthesis
-Renal damage

Receptor agonists (Losartan):
Block AT1-type Receptors
- Contraindicated in pregnancy
15
Q

Name a beta blocker that helps with heart failure

A

Metoprolol (mechanism unknown)

16
Q

Name a beta-agonist that helps with heart failure

A

Dobutamide

17
Q

Name a phosphodiesterase inhibitor that helps with heart failure

A

Theophylline

18
Q

Name a vasodilator that helps with heart failure

A

Nitroglycerin

19
Q

True/False? Heart Failure can lead to fluid accumulation in ankles and lungs

A

True