MBchB study guide

Apr 25th, 2015
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HEART FAILURE [H/F]=cardiac disorder that impairs ability of heart to fnxn asa pump to meet a physiological circulation.*functional*structural+B.P & C.Ocompensatory mechanisms in hemodynamicsoverworkedDemography: wwwIncidenceincreases wt age,Morbidity high, poor prognosis [10 ysr <10%]TDH =causes:^^valvular, ^HT,cardiomyopathy, coronay artery dzA; pump failure1. heart muscle dz-CAD, Cardiomyopathy2. Restrictive filling-constrictive pericarditis, tamponade,restrictive cm3. Impaired heart rate-arrhythmia, heart block, post MI, bblockers4. -ve ionotropy- antiarrhythmics,venomsB; excessive preload-MR, fluid overload(NSAIDS,IV fluids,steroids)C; chronic excessive afterload- AS, HT, PE, COPDD; high output states- anemia,pg,^TFTs,pagets,AVmal,beriberi,hemachromatosisOthers; alcohol,chemo,congenital heart dz (ASD,VSD)Physiological changes inHF/pathophysiological1. dilatation,myocyte hypertrophy,^ collagen synthesis,altered myosin gene expression,altered sarcoplasmic Ca** ATPase density,sympathetic stimulation,^ANP secretion,salt/water retention,peripheral vasoconstrictionPrecipitating/Aggrevating factors {take hx}Anemia, arryhthmia, thyrotoxicosis, pregnancySepsis, pneumonia, IEChange/poor compliance to drugs incl diet e.g saltWhen heart fails, changes occur to the heart & peripheralciculation in response to the hemodynamic statusPrimarily compensatory to maintain CO + peripheralp

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