Heart Failure: Causes and Types
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Questions and Answers

What is the approximate 5-year mortality rate for heart failure?

  • 75%
  • 25%
  • 50% (correct)
  • 90%

    • What is the most common cause of heart failure in the USA?

  • Myocardial infarction
  • Cardiomyopathy
  • Coronary artery disease (correct)
  • Hypertension

    • In systolic failure, what is typically reduced?

  • Stroke volume
  • Ejection fraction (correct)
  • Cardiac output
  • All of the above

    • Which type of heart failure is more common in older patients?

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

    What is a characteristic of diastolic failure?

    <p>Stiffening and loss of adequate relaxation</p> Signup and view all the answers

    What is the trend in the prevalence of heart failure?

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

    What are the two primary goals of treatment in heart failure?

    <p>Reducing symptoms and slowing progression</p> Signup and view all the answers

    What is the name of the plant family that provides medically useful cardiac glycosides?

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

    What is the extent of absorption of digoxin after oral administration?

    <p>65–80%</p> Signup and view all the answers

    Where are cardiac glycosides distributed in the body?

    <p>Widely distributed to tissues, including the CNS</p> Signup and view all the answers

    How is digoxin primarily eliminated from the body?

    <p>Excreted unchanged by the kidneys</p> Signup and view all the answers

    What is the relationship between digoxin's renal clearance and creatinine clearance?

    <p>Directly proportional</p> Signup and view all the answers

    What is the primary mechanism by which cardiac glycosides increase cardiac contractility?

    <p>Inhibition of Na+/K+-ATPase, leading to increased intracellular sodium concentration</p> Signup and view all the answers

    What is the result of the inhibition of Na+/K+-ATPase by cardiac glycosides?

    <p>An increase in intracellular sodium concentration</p> Signup and view all the answers

    What is the role of the sodium-calcium exchanger in the mechanism of cardiac glycosides?

    <p>It reduces calcium expulsion from the cell</p> Signup and view all the answers

    What is the effect of cardiac glycosides on the electrical properties of the heart?

    <p>A mixture of direct and autonomic actions</p> Signup and view all the answers

    What is the mechanism by which cardiac glycosides increase the free calcium concentration in the vicinity of the contractile proteins?

    <p>A two-step process involving Na+/K+-ATPase inhibition and the sodium-calcium exchanger</p> Signup and view all the answers

    What is the therapeutic effect of cardiac glycosides?

    <p>Positive inotropy</p> Signup and view all the answers

    What is the primary effect of cardiac glycosides on the cardiac action potential?

    <p>Early and brief prolongation of the action potential</p> Signup and view all the answers

    What is the main mechanism by which cardiac glycosides slow AV conduction?

    <p>Increasing vagal outflow</p> Signup and view all the answers

    What is the consequence of an excessively rapid ventricular rate?

    <p>Inadequate time for diastolic filling</p> Signup and view all the answers

    What is the effect of larger doses of glycosides on sinus rhythm?

    <p>Disturbance of sinus rhythm</p> Signup and view all the answers

    What is the result of inhibition of the Na+/K+ pump by glycosides?

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

    What is the potential consequence of slowing AV conduction by cardiac glycosides?

    <p>AV block</p> Signup and view all the answers

    What is the consequence of increased [Ca2+]i in the cardiac muscle?

    <p>Coupled beats followed by ventricular tachycardia and eventually ventricular fibrillation</p> Signup and view all the answers

    What is the primary site of digitalis toxicity outside the heart?

    <p>Gastrointestinal tract</p> Signup and view all the answers

    What is the cause of gastrointestinal toxicity associated with digitalis?

    <p>Both direct effects on the gastrointestinal tract and CNS actions</p> Signup and view all the answers

    What is a rare effect of digitalis in men?

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

    What is a possible CNS effect of digitalis?

    <p>Aberrations of color perception</p> Signup and view all the answers

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