Heart Failure and Diastolic Dysfunction Quiz

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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?

Increased ventricular volume corresponds to reduced compliance Signup and view all the answers

Which condition is NOT typically associated with diastolic dysfunction?

Improved diastolic function Signup and view all the answers

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

Destruction of myocardium Signup and view all the answers

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

Hypertension Signup and view all the answers

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

Impaired myocardial energy metabolism Signup and view all the answers

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

Cardiomyocyte apoptosis Signup and view all the answers

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

Cardiogenic shock Signup and view all the answers

What is the primary dysfunction associated with cardiac insufficiency?

Impaired myocardial contractility Signup and view all the answers

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

Horse-running rhythm Signup and view all the answers

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

Decreased myocardial contractility Signup and view all the answers

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

Systemic hypertension Signup and view all the answers

Which type of cardiac overload results from aortic insufficiency?

Volume overload Signup and view all the answers

Which of the following best describes diastolic heart failure?

Decreased ability to relax during filling Signup and view all the answers

What role does vitamin B1 deficiency have in cardiac insufficiency?

Causes myocardial necrosis Signup and view all the answers

What is the outcome of complete compensation in heart failure?

Normal cardiac output Signup and view all the answers

What characterizes acute heart failure?

Rapid onset and sharp decrease of cardiac output Signup and view all the answers

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

Right heart failure Signup and view all the answers

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

Anemia Signup and view all the answers

What classification of heart failure is associated with complete compensation?

Class I Signup and view all the answers

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

Valvular disease Signup and view all the answers

What is a characteristic of chronic heart failure?

Chronic onset with compensatory mechanisms Signup and view all the answers

Which condition is primarily associated with systolic heart failure?

Coronary heart disease Signup and view all the answers

What mechanism contributes to increased cardiac output in cardiac compensation?

Increased heart rate Signup and view all the answers

Which factors contribute to myocardial contractility during cardiac compensation?

Norepinephrine elevation and Ca2+ influx Signup and view all the answers

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

They are directly related within a certain range Signup and view all the answers

What is the role of baroreceptors in cardiac compensation mechanisms?

Stimulating sympathetic activity Signup and view all the answers

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

Immediate and effective contractility improvement Signup and view all the answers

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

Exceeding 180/min heart rate Signup and view all the answers

Which physiological aspect is crucial for understanding cardiac output calculation?

Cardiac output equals stroke volume multiplied by heart rate Signup and view all the answers

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

Peripheral blood vessel contraction Signup and view all the answers

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

Creatine phosphate (CP) Signup and view all the answers

Which condition can cause impaired energy production in the myocardium?

Impairment of pyruvic acid metabolism Signup and view all the answers

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

Impaired contraction and excitation-contraction coupling Signup and view all the answers

What role does acidosis play in the myocardial function?

Slows depolarization rate and affects calcium influx Signup and view all the answers

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

The threshold level for contraction Signup and view all the answers

What is one effect of hyperkalemia on myocardial function?

Depresses β-adrenergic sensitivity to norepinephrine Signup and view all the answers

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

Impairment of creatine phosphate production Signup and view all the answers

Which factor directly impairs cadmium influx in myocardial cells?

Enhanced acidosis in the extracellular environment Signup and view all the answers

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

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Description

Test your knowledge on the mechanisms, symptoms, and complications associated with diastolic dysfunction and heart failure. This quiz covers essential concepts like ventricular compliance, contractility, and myocardial remodeling. Perfect for students and healthcare professionals alike.