Heart Failure Pathophysiology

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Questions and Answers

What is the term for diastolic dysfunction with normal LVEF?

Heart failure with reduced ejection fraction (HFrEF)

Heart failure with preserved ejection fraction (HFpEF) (correct)

Systolic dysfunction with normal ventricular filling

Ventricular stiffness with normal contractility

What is a common cause of systolic dysfunction?

Reduced muscle mass (e.g., myocardial infarction [MI]) (correct)

Ventricular hypertrophy

Increased ventricular stiffness

Diastolic dysfunction with normal LVEF

What is a characteristic of diastolic dysfunction?

Increased ventricular filling

Restriction in ventricular filling (correct)

Decreased ventricular stiffness

Increased contractility

What is a consequence of ventricular hypertrophy?

Diastolic dysfunction with increased ventricular stiffness Signup and view all the answers

Which of the following is NOT a cause of diastolic dysfunction?

Reduced muscle mass Signup and view all the answers

What is the primary characteristic of FC-III patients?

They have marked limitation Signup and view all the answers

Which of the following statements is true about FC-IV patients?

They are unable to carry on physical activity without discomfort Signup and view all the answers

What do FC-III patients and FC-IV patients have in common?

They both experience discomfort during physical activity Signup and view all the answers

Which functional classification category is characterized by an inability to perform physical activity without discomfort?

FC-IV Signup and view all the answers

What is the primary difference between FC-III and FC-IV patients?

Their marked limitation versus inability to perform physical activity Signup and view all the answers

What is the effect of compensatory mechanisms on cardiac function in the initial stages of Heart Failure?

They maintain cardiac function Signup and view all the answers

What is the ultimate consequence of compensatory mechanisms in Heart Failure?

Disease progression and symptoms of HF Signup and view all the answers

What is the relationship between compensatory mechanisms and disease progression in Heart Failure?

They contribute to disease progression Signup and view all the answers

What is the nature of symptoms in Heart Failure?

They are caused by compensatory mechanisms Signup and view all the answers

What is the impact of compensatory mechanisms on cardiac function in the long run?

They lead to disease progression and symptoms of HF Signup and view all the answers

What is the primary step in addressing heart failure?

Determining the underlying cause Signup and view all the answers

What may not be necessary if underlying disorders are treated?

Treatment for heart failure Signup and view all the answers

Which of the following is an example of an underlying disorder that may contribute to heart failure?

Hyperthyroidism Signup and view all the answers

Why is it essential to identify the etiology of heart failure?

To develop a more effective treatment plan Signup and view all the answers

What may be the outcome of treating underlying disorders in patients with heart failure?

Reduced need for heart failure treatment Signup and view all the answers

In which stage of HF would patients be considered for specialized interventions?

Advanced HF with persistent symptoms Signup and view all the answers

What is the primary goal of restricting fluid intake in chronic heart failure?

To reduce fluid buildup in the body Signup and view all the answers

What type of therapy may be considered for patients with advanced HF?

Continuous IV positive inotropic therapy Signup and view all the answers

What is the last resort for patients with end-stage HF?

Heart transplantation Signup and view all the answers

What is the primary focus of non-pharmacologic therapy in chronic heart failure?

Restricting fluid and sodium intake Signup and view all the answers

Study Notes

Heart Failure (HF) Types

4-Diastolic dysfunction with normal LVEF (Left Ventricular Ejection Fraction) is termed HF with preserved ejection fraction (HFpEF)

Pathophysiology of HF

Causes of systolic dysfunction (decreased contractility) include reduced muscle mass (e.g., myocardial infarction [MI])
Causes of diastolic dysfunction (restriction in ventricular filling) include increased ventricular stiffness and ventricular hypertrophy
Compensatory mechanisms (e.g., increased ventricular stiffness, ventricular hypertrophy) initially maintain cardiac function but eventually lead to symptoms of HF and contribute to disease progression

New York Heart Association (NYHA) Functional Classification

FC-III patients have marked limitation of physical activity
FC-IV patients are unable to carry on physical activity without discomfort

General Approach to HF

First step is to determine the etiology or precipitating factors of HF
Treatment of underlying disorders (e.g., hyperthyroidism) may obviate the need for treating HF

Staging of HF

Advanced HF: persistent HF symptoms despite maximally tolerated Guideline-Directed Medical Therapy (GDMT)
Patients with advanced HF should be considered for specialized interventions, including:
- Mechanical circulatory support
- Continuous IV positive inotropic therapy
- Cardiac transplantation

Nonpharmacologic Therapy of Chronic Heart Failure

Interventions include restriction of fluid intake and dietary sodium intake

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Description

This quiz covers the pathophysiology of heart failure, including systolic dysfunction and diastolic dysfunction. Learn about the causes of decreased contractility and restriction in ventricular filling.