Cardiovascular Diseases and Heart Failure
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Questions and Answers

What is a possible cause of pulmonary and systemic venous congestion in patients with normal LV systolic function?

  • Cardiomyopathies
  • Systemic hypertension
  • Coarctation of aorta
  • Myocardial hypertrophy (correct)

    • What can be a consequence of the loss of left atrial contribution to LV late diastolic filling?

  • Cardiac tamponade
  • Pulmonary embolism
  • Increased cardiac output
  • Decreased cardiac output (correct)

    • What is a possible cause of moist rales heard over the lung bases posteriorly?

  • RV failure with transudation of fluid into the alveoli
  • LV failure with transudation of fluid into the alveoli (correct)
  • Cardiac tamponade
  • Pulmonary embolism

    • What can cause an enlarged, tender liver and ascites?

    <p>RV failure</p> Signup and view all the answers

    What is a possible cause of increased pressure work on the heart?

    <p>All of the above</p> Signup and view all the answers

    What can cause slow or incomplete LV filling at normal left atrial pressures?

    <p>All of the above</p> Signup and view all the answers

    What is a possible consequence of cardiomyopathies?

    <p>Impaired cardiac function</p> Signup and view all the answers

    What can cause signs of pleural effusion?

    <p>All of the above</p> Signup and view all the answers

    What percentage of hospitalizations for patients 65 or older is due to heart failure?

    <p>20%</p> Signup and view all the answers

    What is a common age-related change that contributes to LV diastolic dysfunction in older persons?

    <p>Increased LV stiffness</p> Signup and view all the answers

    What is congestive heart failure (CHF) characterized by?

    <p>Pulmonary congestion and systemic venous congestion</p> Signup and view all the answers

    What can be a non-cardiac etiology of heart failure?

    <p>Kidney disease</p> Signup and view all the answers

    What is a complication of heart failure that can lead to inadequate perfusion of tissues?

    <p>Cardiogenic shock</p> Signup and view all the answers

    What is a characteristic of the left ventricle in older persons that can contribute to LV diastolic dysfunction?

    <p>Increased stiffness</p> Signup and view all the answers

    What percentage of Americans over the age of 65 have heart failure?

    <p>1%</p> Signup and view all the answers

    What can be a cause of left ventricular hypertrophy in older persons?

    <p>All of the above</p> Signup and view all the answers

    What is a characteristic of backward effects of left heart failure?

    <p>Increased pulmonary congestion especially when lying down</p> Signup and view all the answers

    What is a possible cause of high output failure?

    <p>Anemia</p> Signup and view all the answers

    What is a potential consequence of left heart failure?

    <p>Right heart failure</p> Signup and view all the answers

    What is a characteristic of high output failure?

    <p>Adequate blood volume and normal or elevated myocardial contractility</p> Signup and view all the answers

    What is another possible cause of high output failure?

    <p>Hyperthyroidism</p> Signup and view all the answers

    What is a potential effect of backward effects of left heart failure?

    <p>Dyspnea</p> Signup and view all the answers

    What is a possible complication of left heart failure?

    <p>Right heart failure</p> Signup and view all the answers

    What is a characteristic of left heart failure?

    <p>Decreased systemic blood pressure</p> Signup and view all the answers

    What is a common cause of right heart failure?

    <p>Persistent left-sided heart failure</p> Signup and view all the answers

    What is a manifestation of right heart failure?

    <p>Increased right atrial, RV end-diastolic, and systemic venous pressure</p> Signup and view all the answers

    What is a potential consequence of cardiomyopathy?

    <p>Right heart failure</p> Signup and view all the answers

    What is a common complication of chronic pulmonary disease?

    <p>Right heart failure</p> Signup and view all the answers

    What is a potential effect of tricuspid valve stenosis?

    <p>Right heart failure</p> Signup and view all the answers

    What is a manifestation of forward heart failure?

    <p>Decreased cardiac output</p> Signup and view all the answers

    What is a potential consequence of pulmonary embolism?

    <p>Right heart failure</p> Signup and view all the answers

    What is a common cause of cor pulmonale?

    <p>Chronic pulmonary disease</p> Signup and view all the answers

    What is the primary consequence of backward effects of right heart failure on venous circulation?

    <p>Increased venous pressure leading to edema</p> Signup and view all the answers

    What is the effect of left heart failure on cardiac output?

    <p>Decreased cardiac output due to decreased left ventricular end-diastolic pressure</p> Signup and view all the answers

    Which of the following is a forward effect of right heart failure?

    <p>Decreased pulmonary blood flow</p> Signup and view all the answers

    What is the effect of left heart failure on pulmonary circulation?

    <p>Increased congestion in the pulmonary circulation</p> Signup and view all the answers

    What is the primary mechanism of decreased cardiac output in right heart failure?

    <p>Decreased pulmonary blood flow leading to decreased left heart filling</p> Signup and view all the answers

    Which of the following conditions is associated with left heart failure?

    <p>All of the above</p> Signup and view all the answers

    What is the effect of right heart failure on systemic blood pressure?

    <p>Decreased systemic blood pressure due to decreased cardiac output</p> Signup and view all the answers

    What is the primary consequence of left heart failure on the kidneys?

    <p>Decreased renal blood flow leading to decreased urine output</p> Signup and view all the answers

    Study Notes

    Heart Failure

    • Heart failure is a general term used to describe impaired pumping ability of the heart, resulting in inadequate perfusion of tissues.
    • ~1% of Americans over the age of 65 have heart failure.
    • 20% of hospitalizations for patients 65 or older is due to heart failure.

    Causes of Heart Failure

    • Impaired cardiac function:
      • Myocardial disease (MI, cardiomyopathies, myocarditis)
      • Valvular heart disease (both stenotic and regurgitant disease can progress to failure)
    • Excess work demands:
      • Increased pressure work (systemic hypertension, pulmonary hypertension, coarctation of aorta)
      • Increased volume work (arterio-venous shunts, excessive administration of IVF)
      • Increased perfusion work (anemia, thyrotoxicosis)

    Left Sided Heart Failure

    • Failure of left heart to move blood from the pulmonary circulation into the systemic circulation
    • Leading to a decrease in cardiac output
    • Increase in left atrial and left ventricular end-diastolic pressures
    • Congestion in the pulmonary circulation
    • Associated conditions:
      • Acute myocardial infarction
      • Stenosis or regurgitation of mitral/aortic valves
      • Rapid infusion of IVF or blood

    Forward and Backward Effects of Left Heart Failure

    • Forward effects:
      • Decreased systemic blood pressure
      • Fatigue
      • Increased heart rate
      • Decreased urine output
    • Backward effects:
      • Increased pulmonary congestion (especially when lying down)
      • Dyspnea (difficulty breathing)
      • Right heart failure if condition worsens

    Right Heart Failure

    • Failure of right heart to pump blood forward into the pulmonary circulation
    • Leading to accumulation or damming back of blood in the systemic venous side
    • Increase in right atrial, RV end-diastolic, and systemic venous pressure
    • Causes:
      • Conditions that restrict blood flow into lungs
      • Stenosis or regurgitation of tricuspid or pulmonic valves
      • Cardiomyopathy
      • Persistent left-sided failure
      • Acute or chronic pulmonary disease (pneumonia, pulmonary emboli, pulmonary hypertension)

    Forward and Backward Effects of Right Heart Failure

    • Forward effects:
      • Decreased pulmonary blood flow
      • Decreased blood oxygenation
      • Fatigue
      • Decreased systemic blood pressure (due to decreased left heart filling)
    • Backward effects:
      • Increased venous pooling of blood
      • Edema of hands and feet
      • Ascites
      • Jugular vein distension
      • Hepatomegaly and splenomegaly

    High Output Failure

    • Despite adequate blood volume and normal or elevated myocardial contractility, the heart increases its output but the body's needs are still not met
    • Causes:
      • Anemia (increases heart rate and stroke volume to increase O2 carrying capacity)
      • Sepsis (systemic vasodilation causes hypotension and increased heart workload)
      • Hyperthyroidism (increased thyroxine levels increase BMR)
      • Beriberi (thiamine deficiency, impairs cellular metabolism in tissues)

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    Related Documents

    NU608 Heart Failure PDF

    Description

    This quiz covers the different causes of heart failure, including impaired cardiac function and excess work demands. Learn about the various conditions that can lead to heart failure, such as myocardial disease, valvular heart disease, and more.

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