Term
| What are the 7 possible etiologies that can lead to heart failure? |
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Definition
-valve leakage caused by degen (endocardiosis), valve infection (endocarditis), or congenital malformations
-semilunar (pulmonic and aortic) valve stenosis or chronic afterload elecation
-acquired myocardial dz: hypertrophic and dilated cardiomyopathy
-myocardial damage: enfection, toxin, or nutritional deficiency
-volume recirculation: PDA and VSD
-pericardial dz
-primary tachyarrhythmias |
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Term
| What is the doctor word for contractility? |
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Definition
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Term
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Definition
-intrinsic property of sarcomere to shorten: Actin-Myosin interaction
-ability of ventricle to generate force |
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Term
| HOw do we measure contractility? |
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Definition
| -estimated echocardiographically via systolic function |
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Term
| What is the doctor word for relaxation? |
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Definition
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Term
| Is relaxation active or passive? |
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Definition
| -both active (Ca reuptake) and passive components |
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Term
| What is the gold standard for measuring relaxation? |
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Definition
-invasive catheterization
-difficult to estimate on ultrasound |
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Term
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Definition
| -force that opposes ventricular ejection |
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Term
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Definition
| -resistance must be overcome for ventricle to efect blood |
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Term
| Does afterload eual blood pressure? Why or why not? |
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Definition
-no
-afterload is actually systemic vascular resistance |
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Term
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Definition
-the pressure that stretches the right or left ventricles prior to contraction (systole)
-both presser and volume dependent |
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Term
| What does the Frank-Starling curve say? |
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Definition
| -the more you stretch the heart the better your CO is |
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Term
| What is the doctor word for heart rate? |
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Definition
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Term
| Heart rate is a constant battle b/n symp and para tone. HOw does heart failure affect this? |
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Definition
-heart failure inc symp tone
-vagal tone elevated: CNS, ocular, resp, and GI dz |
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Term
| What is the myosin head? What do they do? |
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Definition
-site for binding ATP and site for binding action
-interact w/ troponin mmolecules and rachets along |
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Term
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Definition
| -myosin protein filaments |
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Term
| Which molecule is most important for myocardial function? Where is it stored? |
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Definition
-Ca
-stored in SR but also comes from ECF via L-type Ca chh |
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Term
| How is myocyte contraction regulated? |
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Definition
| -number of active Actin-myosin cross bridges: # of myofibrils brought to full activation, amount of Ca release from SR, sarcomere stretch |
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Term
| What is systolic failure? |
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Definition
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Term
| What are some of the etiologies of systolic failure? |
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Definition
-valve leakage: degen, valve infection, or congenital malformatioins
-dialted cardiomyopathy
-myocardial damage
-V recirculation due to congenital defects
-primary tachyarrhythmias |
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Term
| What is diastolic failure? |
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Definition
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Term
| What are some of the etiologies of diastolic failure? |
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Definition
-chornic afterload elevation: systemic hypertension
-hypertrophic cardiomyopathy
-pericardial dz: fluid accumulatio or constriction
-semilunar (ulmonic and aortic) valve stenosis |
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Term
| What is the difference b/n CHF and low output HF? |
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Definition
-CHF: back of fluid
-LO: not getting enough blood in the forward direction |
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Term
| What are some of the signs of decreased forward blood flow? |
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Definition
-hypotension
-hypothermia
-bradycardia
-cold extremities
-pale mucous membranes |
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Term
| What are some of the clinical signs of CHF? |
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Definition
| -signs of fluid retention: pulmonary edema,ascites, pleural effusion, pericardial effusion, weight gain |
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Term
Are the following types of CHF right-sided or left-sided:
a) pulmonary edema
b) ascites
c) pleural effusions
d) pericardial effusion |
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Definition
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Term
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Definition
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Term
| Do most cardiac diseases affect HR or SV? Any exceptions? |
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Definition
-SV
-exception: tachycardia induce cardiomyopathies |
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Term
| What are some of the effects of dec SV? |
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Definition
-remodeling: eccentric or concentric hypertrophy
-elevted catecholamines (NE/Epi): inc HR, inc O2 consumption, dec diastole time
-renal effects: Renin, angiotensin, aldosterone, RAAS |
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Term
| What are the effects of Renin, angiotensin, aldosterone, and RAAS released by the renal system in response to dec SV? |
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Definition
-inc Afterload
-fibrosis
-VOLUME RETENTION |
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Term
| What are some insults that result in eccentric hypertrophy? |
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Definition
-valve leakage caused by degen (endocardiosis), valve infection (Endocarditis), or congenital malformations
-adult onset (DCM)
-volume recirculation caused by conetial defects (PDA, VSD)
-myocardial damage |
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Term
| What are some insults that result in concentric hypertrophy? |
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Definition
-valve carrowing: stenosis
-chronic afterload elevation (systemic and pulmonary hypertension)
-adult onset myocardial dz HCM |
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Term
| What are some of the remodeling processes that occur due to dec SV? |
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Definition
-cell death: apoptosis
-fibrosis
-progressive remodeling leads to worsening SV and CO |
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Term
| What are the three main mechanisms that cause arrhythmias? |
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Definition
-inc automaticity
-re-entry: tissue makes an unusual circuit
-abnormal Ca cycling: more common |
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Term
| What is a common cause of inc automaticity? |
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Definition
| -abnormal electrical conduction due to ventricular ectopic foci due to ventricle irritation |
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