T1 L6: How the Cardiovascular System Fails

• Cerebral blood vessel rupture?

  haemorrhagic stroke
• Cerebral blood vessel blockage?

  ischaemic stroke
• Coronary heart disease / ischaemic heart disease primary cause?

  atherosclerosis
• Sympathetic activity during acute myocardial infarction?

  release of adrenaline and noradrenaline; response to pain and to haemodynamic abnormalities.
• How does sympathetic activity help to compensate during heart failure?

  increase heart rate and contractility
• fluid that leaves the blood causing fluid accumulation in tissue?

  transudate
• Pulmonary oedema is usually caused by ____, due to damming of blood, so hydrostatic pressure increase in pulmonary circulation?

  left heart failure
• Accumulation of fluid in the peritoneal cavity?

  ascites
• Maintaining homeostasis of a physiological function despite stressors or malfunctions. Happens via endogenous physiological feedback?

  compensation
• ACE inhibitors (angiotensin converting enzyme) or spironolactone (potassium diuretic) are used to treat?

  cardiac remodelling
• Ventricular hypertrophy where ventricle dilates due to volume overload?

  eccentric remodelling
• Ventricular hypertrophy where ventricle thickens due to pressure overload?

  concentric remodelling
• What type of heart failure causes respiratory symptoms?

  left heart failure
• What type of heart failure causes systemic symptomss?

  right heart failure
• Heart failure symptomss?

  fatigue, peripheral oedema, paroxysmal nocturnal dyspnoea, orthopnoea (shortness of breath while laying down)
• What is the end stage of decompensated heart failure?

  cardiogenic shock
• Cardiogenic shock progresses by what kind of feedback?

  positive feedback
• ACE Inhibitors, diuretics, beta blockers - treatment for?

  chronic heart failure
• Internal bleeding - Loss of fluid leads to loss of pressure, ends with shock?

  haemorrhage
• Decompensated heart failure mechanism?

  low perfusion ➝ kidney responds as if haemorrhage ➝ increases plasma volume ➝ fluid overload ➝ heart unable to pump extra fluid ➝ fluid damming ➝ increased venous hydrostatic pressure ➝ increased back pressure ➝ positive feedback loop ➝ rapid deterioration
• Low output heart failure treatment goals?

  1. prevent acute decompensated heart failure
  2. counteract cardiac remodelling
  3. minimize symptoms