Cardiac Function and Heart Failure
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Questions and Answers

What is the consequence of elevated left ventricular pressure during diastole?

  • Decreased pulmonary capillary hydrostatic pressure
  • Transudation of fluid into the pulmonary interstitium (correct)
  • Reduced ejection fraction
  • Increased left atrial pressure

Which condition may result from impaired diastolic relaxation or mechanical obstruction?

  • Arrhythmogenic right ventricular cardiomyopathy
  • Heart failure with preserved ejection fraction (correct)
  • Dilated cardiomyopathy
  • Systolic heart failure

Which of the following conditions leads to diastolic dysfunction due to reduced chamber compliance?

  • Myocardial ischemia (correct)
  • Aortic regurgitation
  • Coronary artery disease
  • Ventricular septal defect

What happens when the right ventricle fails?

<p>Elevation of systemic venous pressure (D)</p> Signup and view all the answers

What is the most common cause of isolated right ventricular failure?

<p>Left-sided heart failure (C)</p> Signup and view all the answers

What primarily affects stroke volume in a healthy heart?

<p>Ventricular afterload and contractility (D)</p> Signup and view all the answers

Which of the following conditions is associated with impaired myocardial contractility?

<p>Dilated cardiomyopathy (B)</p> Signup and view all the answers

How does increased preload typically affect stroke volume according to the Frank-Starling mechanism?

<p>It induces a compensatory rise in stroke volume (C)</p> Signup and view all the answers

What does afterload refer to in the context of cardiac function?

<p>The pressure the ventricle must overcome to eject blood (C)</p> Signup and view all the answers

What is a consequence of impaired contractility in the heart?

<p>Elevated end-diastolic volume due to reduced systolic emptying (D)</p> Signup and view all the answers

In which situation would you expect to see increased afterload?

<p>In a patient with aortic stenosis (C)</p> Signup and view all the answers

What is normally true of the cardiac output in a healthy individual?

<p>It can increase or decrease based on heart rate and stroke volume (C)</p> Signup and view all the answers

Which of the following is NOT a mechanism affecting stroke volume?

<p>End-systolic volume (A)</p> Signup and view all the answers

Flashcards

Cardiac output

The amount of blood pumped by the heart per minute, adjusted to meet the body's metabolic needs.

Stroke volume

The volume of blood ejected from the ventricle with each heartbeat.

Ventricular Preload

The stretch on the heart muscle before contraction, influencing stroke volume.

Ventricular Afterload

The resistance the heart must overcome to pump blood out, influencing stroke volume.

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Myocardial Contractility

The heart muscle's ability to contract, independent of preload and afterload.

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Systolic Heart Failure

Heart failure where the heart struggles to push blood out, due to low contractility or high afterload.

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Impaired Ventricular Filling

A cause of heart failure where the heart has trouble filling properly.

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Frank-Starling Mechanism

The heart's ability to increase stroke volume in response to increasing preload.

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Diastolic Dysfunction

The heart's inability to relax and fill properly during the diastole phase, leading to reduced filling of the ventricle.

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Pulmonary Congestion

Fluid buildup in the lungs due to increased pressure in the pulmonary capillaries, causing symptoms like shortness of breath and coughing.

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Elevated Left Ventricular Pressure

Increased pressure in the left ventricle, often caused by reduced chamber compliance or obstruction, ultimately leading to pulmonary congestion.

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Right Ventricular Afterload

The resistance the right ventricle needs to overcome to pump blood to the lungs, often increased due to lung or pulmonary vessel problems.

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Systemic Vein Congestion

Backed up blood in the veins of the body due to increased pressure in the right atrium, often a result of right ventricular failure.

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Study Notes

Cardiac Function and Heart Failure

  • Heart accepts blood at low pressure during diastole, then propels it at higher pressures in systole.
  • Cardiac output matches metabolic needs via heart rate and stroke volume adjustments.
  • Stroke volume depends on preload, afterload, and contractility.
  • Preload (stretch on myocardial fibers) increases ventricular output within physiological limits.
  • Afterload (ventricular wall stress during ejection) reflects resistance to emptying and determines end-systolic volume, independent of preload.
  • Contractility refers to changes in contraction force, independent of preload/afterload, increased by actin-myosin cross-bridge cycling.
  • Heart failure grouped by impaired contractility, increased afterload, or impaired filling.
  • Systolic HF: reduced ventricle ejection due to impaired contractility or high afterload.
  • Loss of contractility causes destruction of myocytes, abnormal function or fibrosis (e.g., dilated cardiomyopathy, volume overload, ischemia/infarction).
  • Pressure overload impairs ejection, raising the end-systolic volume.
  • Increased end-systolic volume plus normal pulmonary return elevates end-diastolic volume and pressure.
  • Excessive afterload causes conditions like uncontrolled hypertension and aortic stenosis.
  • While increased preload increases stroke volume (Frank-Starling), impaired contractility or afterload maintain elevated end-diastolic volume.
  • Elevated left ventricular pressure during diastole transmits to left atrium, pulmonary veins, and capillaries, causing pulmonary congestion.
  • Heart failure with preserved ejection fraction results from impaired ventricular filling (mechanical obstruction or impaired diastolic relaxation).
  • Conditions like left ventricular hypertrophy, hypertrophic cardiomyopathy, restrictive cardiomyopathy, and myocardial ischemia cause reduced chamber compliance and diastolic dysfunction.
  • Mitral stenosis and pericardial constriction obstruct filling, needing elevated diastolic pressures.
  • Isolated right ventricular failure is less common, usually from increased right ventricular afterload (lung/pulmonary vessel disease).
  • Most common cause of right ventricular failure is left-sided heart failure leading to elevated pulmonary vascular pressure and right ventricular afterload.

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Description

Explore the intricacies of cardiac function and the mechanisms behind heart failure. This quiz covers concepts such as stroke volume, preload, afterload, and contractility, as well as the different types of heart failure. Test your understanding of how these elements interact to maintain heart health.

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