Heart Failure and Diastolic Dysfunction Quiz

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary issue associated with diastolic dysfunction?

  • Improved ventricular compliance
  • Increased cytoplasmic Ca2+ levels
  • Rapid decrease of ATP supply
  • Impaired dissociation of the myosin-actin complex (correct)

Which factor contributes to reduced ventricular compliance?

  • Increased potential energy during diastole
  • Decreased intraventricular pressure
  • Delayed repositioning of Ca2+ (correct)
  • Enhanced myocardial hypertrophy

What is a symptom of low output syndrome in cardiac insufficiency?

  • Decreased cardiac pump function (correct)
  • Reduced arterial blood pressure
  • Increased cardiac output
  • Normal blood redistribution

Which statement best describes the relationship between intraventricular pressure and ventricular volume?

<p>Increased ventricular volume corresponds to reduced compliance (C)</p> Signup and view all the answers

Which condition is NOT typically associated with diastolic dysfunction?

<p>Improved diastolic function (C)</p> Signup and view all the answers

What is a key factor contributing to depressed contractility in heart failure?

<p>Destruction of myocardium (B)</p> Signup and view all the answers

Which condition is NOT associated with myocardial damage leading to heart failure?

<p>Hypertension (D)</p> Signup and view all the answers

What mechanism might lead to intracellular Ca2+ overload during heart failure?

<p>Impaired myocardial energy metabolism (B)</p> Signup and view all the answers

Which process is directly related to the remodeling of the myocardium in heart failure?

<p>Cardiomyocyte apoptosis (C)</p> Signup and view all the answers

What is a consequence of myocardial infarction involving more than 40% of the left ventricle?

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

What is the primary dysfunction associated with cardiac insufficiency?

<p>Impaired myocardial contractility (A)</p> Signup and view all the answers

Which of the following is a common precipitating factor of heart failure?

<p>Horse-running rhythm (C)</p> Signup and view all the answers

Which of the following is a characteristic of systolic heart failure?

<p>Decreased myocardial contractility (D)</p> Signup and view all the answers

What condition is associated with pressure overload leading to heart failure?

<p>Systemic hypertension (C)</p> Signup and view all the answers

Which type of cardiac overload results from aortic insufficiency?

<p>Volume overload (B)</p> Signup and view all the answers

Which of the following best describes diastolic heart failure?

<p>Decreased ability to relax during filling (A)</p> Signup and view all the answers

What role does vitamin B1 deficiency have in cardiac insufficiency?

<p>Causes myocardial necrosis (B)</p> Signup and view all the answers

What is the outcome of complete compensation in heart failure?

<p>Normal cardiac output (B)</p> Signup and view all the answers

What characterizes acute heart failure?

<p>Rapid onset and sharp decrease of cardiac output (D)</p> Signup and view all the answers

Which type of heart failure is associated with systemic circulatory congestion?

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

In which condition would you most likely see high-output heart failure?

<p>Anemia (C)</p> Signup and view all the answers

What classification of heart failure is associated with complete compensation?

<p>Class I (B)</p> Signup and view all the answers

Which of the following could lead to low-output heart failure?

<p>Valvular disease (B)</p> Signup and view all the answers

What is a characteristic of chronic heart failure?

<p>Chronic onset with compensatory mechanisms (A)</p> Signup and view all the answers

Which condition is primarily associated with systolic heart failure?

<p>Coronary heart disease (A)</p> Signup and view all the answers

What mechanism contributes to increased cardiac output in cardiac compensation?

<p>Increased heart rate (A)</p> Signup and view all the answers

Which factors contribute to myocardial contractility during cardiac compensation?

<p>Norepinephrine elevation and Ca2+ influx (B)</p> Signup and view all the answers

According to the Frank-Starling law, what relationship exists between myocardial initial length and contraction force?

<p>They are directly related within a certain range (A)</p> Signup and view all the answers

What is the role of baroreceptors in cardiac compensation mechanisms?

<p>Stimulating sympathetic activity (A)</p> Signup and view all the answers

What is an effect of cardiac tonogenic dilation in response to increased myocardial demand?

<p>Immediate and effective contractility improvement (C)</p> Signup and view all the answers

What can lead to a limited increase in heart rate during cardiac compensation?

<p>Exceeding 180/min heart rate (D)</p> Signup and view all the answers

Which physiological aspect is crucial for understanding cardiac output calculation?

<p>Cardiac output equals stroke volume multiplied by heart rate (D)</p> Signup and view all the answers

Which of the following is NOT a form of cardiac compensation?

<p>Peripheral blood vessel contraction (C)</p> Signup and view all the answers

What is the primary form of energy storage in the myocardium?

<p>Creatine phosphate (CP) (C)</p> Signup and view all the answers

Which condition can cause impaired energy production in the myocardium?

<p>Impairment of pyruvic acid metabolism (A)</p> Signup and view all the answers

Reduced influx of extracellular Ca2+ can lead to which of the following?

<p>Impaired contraction and excitation-contraction coupling (A)</p> Signup and view all the answers

What role does acidosis play in the myocardial function?

<p>Slows depolarization rate and affects calcium influx (D)</p> Signup and view all the answers

Impaired Ca2+ binding to troponin affects which aspect of myocardial function?

<p>The threshold level for contraction (C)</p> Signup and view all the answers

What is one effect of hyperkalemia on myocardial function?

<p>Depresses β-adrenergic sensitivity to norepinephrine (B)</p> Signup and view all the answers

What is a consequence of high creatine kinase activity in the myocardium?

<p>Impairment of creatine phosphate production (B)</p> Signup and view all the answers

Which factor directly impairs cadmium influx in myocardial cells?

<p>Enhanced acidosis in the extracellular environment (D)</p> Signup and view all the answers

Flashcards

Cardiac Insufficiency

A condition where the heart cannot pump blood effectively to meet the body's needs.

Heart Failure

A condition where the heart's ability to pump blood is so compromised that it causes symptoms and complications.

Primary Dysfunction of Myocardial Systole & Diastole

Conditions that directly damage the heart muscle, leading to impaired pumping ability.

Cardiac Overload

Conditions that put excessive strain on the heart, forcing it to work harder than usual, eventually leading to failure.

Signup and view all the flashcards

Restricted Cardiac Filling

Conditions that restrict the ability of the heart to fill with blood effectively, leading to reduced output.

Signup and view all the flashcards

Precipitating Factors of Heart Failure

Factors that trigger or worsen existing heart failure.

Signup and view all the flashcards

Compensatory Response in Cardiac Insufficiency

The heart compensates for reduced pumping ability by increasing its workload, but this can eventually lead to further damage.

Signup and view all the flashcards

Pathogenesis of Heart Failure

The underlying mechanisms and processes that contribute to the development and progression of heart failure.

Signup and view all the flashcards

Acute heart failure

A type of heart failure characterized by rapid onset and a significant decrease in cardiac output within a short period.

Signup and view all the flashcards

Chronic heart failure

A type of heart failure characterized by a gradual onset and often accompanied by compensatory mechanisms like increased blood volume and heart muscle remodeling.

Signup and view all the flashcards

Left heart failure

Heart failure affecting the left side of the heart, causing congestion in the lungs.

Signup and view all the flashcards

Right heart failure

Heart failure affecting the right side of the heart, causing congestion in the body.

Signup and view all the flashcards

Whole heart failure

Heart failure affecting both the left and right sides of the heart.

Signup and view all the flashcards

Low-output heart failure

A type of heart failure where the heart's ability to pump blood is significantly reduced.

Signup and view all the flashcards

High-output heart failure

A type of heart failure where the heart pumps enough blood but the body has an increased demand.

Signup and view all the flashcards

Systolic heart failure

Heart failure caused by a weakened heart muscle, resulting in a decrease in the heart's ability to contract.

Signup and view all the flashcards

Cardiac Compensation

The body's natural response to heart failure, aiming to maintain adequate blood flow and organ function despite the weakened heart.

Signup and view all the flashcards

Increased Heart Rate

The heart beats faster to pump more blood per minute.

Signup and view all the flashcards

Positive Inotropic Actions

Hormones like adrenaline increase the strength of heart contractions.

Signup and view all the flashcards

Cardiac Tonogenic Dilation

The chambers of the heart enlarge to hold more blood, potentially improving output.

Signup and view all the flashcards

Myocardial Hypertrophy

The heart muscle thickens, allowing it to pump more forcefully.

Signup and view all the flashcards

Cardiac Output

The amount of blood pumped by the heart per minute.

Signup and view all the flashcards

Frank-Starling Law

The law describing the relationship between the initial length of heart muscle fibers and the force of contraction.

Signup and view all the flashcards

Sliding Filament Theory

The overlap of thin and thick filaments in heart muscle fibers, which determines the strength of contraction.

Signup and view all the flashcards

Myocardial Destruction

Destruction of heart muscle cells, primarily caused by factors like oxygen deprivation (ischemia), infection, toxins, and calcium overload.

Signup and view all the flashcards

Cardiomyocyte Necrosis

A key mechanism in heart failure, where the heart muscle cells die due to lack of oxygen or other harmful conditions.

Signup and view all the flashcards

Cardiomyocyte Apoptosis

A programmed cell death process that also contributes to heart failure. It can be initiated by factors like oxidative stress and calcium overload.

Signup and view all the flashcards

Ventricular Remodeling

A vital aspect of heart failure pathogenesis that involves the heart's response to damage. It can lead to hypertrophy (enlargement) or dilation (expansion) of the heart chambers.

Signup and view all the flashcards

Diastolic Dysfunction

A condition where the heart muscle's ability to relax and fill with blood is impaired, leading to reduced cardiac output.

Signup and view all the flashcards

Ventricular Compliance

The ability of the ventricle to expand and accommodate increasing volumes of blood during diastole.

Signup and view all the flashcards

Reduced Ventricular Compliance

A decrease in ventricular compliance, making it harder for the ventricle to fill with blood during diastole.

Signup and view all the flashcards

Impaired Dissociation of Myosin-Actin Complex

The inability of the myosin-actin complex to detach quickly enough, leading to delayed relaxation and reduced filling.

Signup and view all the flashcards

Delayed Repositioning of Calcium

Calcium ions are not taken up by the sarcoplasmic reticulum fast enough, prolonging the contraction and hindering relaxation.

Signup and view all the flashcards

Impaired Myocardial Energy Production

Reduced production of ATP (energy) within the heart muscle due to problems with glycolysis, pyruvate metabolism, or mitochondrial function.

Signup and view all the flashcards

Impaired Myocardial Energy Storage

Insufficient storage of energy in the heart muscle due to low levels of creatine phosphate (CP), which is the main energy storage molecule.

Signup and view all the flashcards

Impaired Myocardial Energy Utilization

Inability of the heart muscle to use energy effectively due to increased workload, leading to inefficient muscle contraction.

Signup and view all the flashcards

Dysfunction of Excitation-Contraction Coupling

A complex process where electrical signals trigger muscle contraction. It is impaired when there are problems with calcium (Ca2+) influx, storage, or binding to troponin.

Signup and view all the flashcards

Reduced Influx of Extracellular Ca2+

Problems with the voltage-operated calcium channel (VOC) and receptor-operated calcium channel (ROC) can reduce calcium influx into heart cells.

Signup and view all the flashcards

Acidosis and H+ Impair Ca2+ Influx

Acidosis (excess acidity) and increased hydrogen ions (H+) can interfere with calcium influx, impair the function of calcium channels, and make the heart more susceptible to potassium (K+) competition.

Signup and view all the flashcards

Disorder of Sarcoplasmic Reticular Handling of Ca2+

The sarcoplasmic reticulum (SR) is the heart cell's calcium storage unit. Reduced SR uptake, reserves, or release of calcium can lead to impaired muscle contraction.

Signup and view all the flashcards

Disorder of Ca2+ Binding to Troponin

Hydrogen ions (H+) compete with calcium for binding to troponin, preventing the triggering of muscle contraction.

Signup and view all the flashcards

Study Notes

Heart Failure Pathophysiology

  • Chapter 11: Overview of heart failure pathophysiology
  • Content Outline:
    • Etiology of cardiac insufficiency
    • Classification of heart failure
    • Compensatory response in cardiac insufficiency
    • Pathogenesis of heart failure
    • Alterations of metabolism and function in cardiac insufficiency
    • Pathophysiology basis of prevention and treatment for cardiac insufficiency
  • Objectives: Define cardiac insufficiency and heart failure, understand pathogenesis and manifestation. Understand etiologies, precipitating factors, classification, and compensatory responses. Understand pathophysiology basis of prevention and treatment

Anatomy Review (Diagram)

  • Diagram shows the heart's chambers and major blood vessels, including the Vena Cava & Aorta
  • Blood flow through the heart is clearly illustrated.

Morbidity of Heart Disease

  • A pie chart displays the relative proportions of different causes of heart disease.
  • The chart's data suggests that Cardiovascular disease (CVD), is a significant health issue.

Patient Death and Medical History

  • Jim Cantalupo died of myocardial infarction in April 2004, potentially highlighting the importance of preventative measures.

Cardiac Insufficiency Key Concepts

  • Heart insufficiency involves complete, incomplete, and decompensated stages.
  • Medical term: xīn gōng néng bù zuán

Heart Failure Definition

  • Heart failure is a condition where systolic and/or diastolic cardiac function results in reduced cardiac output, meaning the body's metabolic requirements cannot be met.
  • The medical term: xīn lì shuāi jié

Clinical Manifestations (Images)

  • Images depict physical signs of heart failure, like edema, congestion, and other symptoms

Etiology of Cardiac Insufficiency

  • Causes: The lecture covers the main causes of cardiac insufficiency.
  • Precipitating Factors: The lecture also addresses precipitating factors leading to heart failure.

Causes of Cardiac Insufficiency

  • Primary Dysfunction of Myocardial Systole and Diastole
    • Myocarditis
    • Myocardiopathy
    • Myocardial necrosis
    • Fibrosis
    • Myocardial ischemia from Coronary artery disease
    • Vitamin B1 deficiency
  • Cardiac Overload
    • Mitral or aortic insufficiency
    • Chronic anemia
    • Hyperthyroidism
    • Systemic hypertension
    • Pulmonary hypertension
  • Restricted Cardiac Filling
    • Constrictive pericarditis

Precipitating Factors

  • Infection (respiratory infection highlighted)
  • Arrhythmias (Horse-running rhythm mentioned)
  • Pregnancy and Delivery
  • Acid-base/electrolyte Disturbances (Acidosis & hyperkalemia)
  • Other Factors

Classification of Heart Failure

  • Rapidity of Onset: Acute & Chronic heart failure
  • Heart Side Involvement: Left, Right, & Whole heart failure
  • Cardiac Output: Low – output & High- output heart failure
  • Systolic and Diastolic Dysfunction (Systolic & Diastolic heart failure)
  • Severity: Mild, Moderate & Severe heart failure

Compensatory Responses in Cardiac Insufficiency

  • Cardiac Compensation: Increased heart rate, Positive inotropic actions of catecholamines, Cardiac tonogenic dilation, Myocardial hypertrophy
  • Extracardiac Compensation: Increased blood volume, Redistributed blood flow, Erythrocytosis, Increased tissue capability to utilize oxygen (cellular compensation).
  • Neurohumoral mechanisms are also involved

Pathogenesis of Heart Failure

  • Mechanism Explanation:
    • Depressed contractility (including destruction of myocardium, impairment of myocardial energy metabolism, and dysfunction of excitation-contraction coupling)
    • Diastolic dysfunction (related to delayed repositioning of Ca2+, impaired dissociation of the myosin-actin complex, decreased potential energy for ventricular diastole, and reduced ventricular compliance).
    • Asynergic of contraction and relaxation

Alterations of Metabolism and Function

  • Low output syndrome (forward failure): decreased cardiac pump function, changes in arterial blood pressure, and blood redistribution
  • Venous congestion syndrome (backward failure): pulmonary congestion, systemic circulation congestion, pulmonary circulation edema, manifestations include dyspnea, orthopnea, and possibly coughing.

Pathophysiology Basis of Prevention and Treatment

  • Prevention and Treatment Strategies:
    • Treating underlying diseases and eliminating precipitating factors
    • Regulating neurohormonal imbalance and myocardial remodeling
    • Reducing cardiac volume load and pressure load
    • Improving myocardial systolic and diastolic function
    • Correcting water-electrolyte and acid-base imbalances

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Related Documents

More Like This

Heart Dysfunction Overview
47 questions
HARD QUIZ PATHOPHYS OF HF
30 questions
Heart Failure: Systolic vs Diastolic
45 questions
Use Quizgecko on...
Browser
Browser