NURBN 2023 - Cardiac
Define heart failure - ANS-The inability of the ventricles to pump enough blood to meet
the body's metabolic demands. Loss of contraction leads to heart failure.
systolic heart failure - ANS-inability of the heart to generate an adequate cardiac output
to perfuse vital tissues
diastolic heart failure - ANS-ventricles can't relax and fill
cause of heart failure - ANS-Atherosclerosis. Hypertension. High cholesterol. Smoking.
Clinical symptoms of hear failure - ANS-Hypertension. Shortness of breath/congested
lungs. Fluid retention/oedema . Chest pain. Tachycardia.
Pathophysiology of heart failure - ANS-Dysfunctional ventricle that is unable to eject
enough blood (systolic dysfunction)
Inability of ventricles to fill with enough blood (diastolic dysfunction)
Ischemic heart disease & HTN are the most common underlying causes
- HTN: excess mechanical stress on ventricles -> structural change of hypertrophy &
eventual left ventricular dysfunction
Differences between left and right heart failure - ANS-Left: fluid build up in the lungs and
Right: fluid retention in peripheral organs and tissue.
Causes of CHF (Right-sided) - ANS-Congestion of peripheral tissues
Pathophysiological steps in HF patients - ANS-- Myocardial injury --> *fall in LV*
performance (lower cardiac output)
, - *Kidneys* sense decreased perfusion, *secrete renin to vasoconstrict + retain Na+ and
H20* via aldosterone; also stimulates sympathetic
- Heart *works against increased filling pressure*; more myocardial injury +
hypoperfusion + downregulate B-receptors
- Main point is that it is a *vicious cycle* caused by *compensatory mechanisms*
How does the RAAS system lead to raised blood pressure? - ANS-Angiotensinogen
converted to angiotensin 1 (by renin from kidneys)
AT-1 to AT-2 via ACE (from pulmonary and renal epithelium) - angiotensin 2 leads to
vasoconstriction and raised ADH from posterior pituitary gland
Aldosterone (ADH) increases water absorption - BP increases
Define arrhythmia - ANS-Any variation from the normal electrical rate and/or sequence
of cardiac activity.
bradyarrhythmia - ANS-slow, irregular heartbeat
tachyarrhythmia - ANS-a fast, irregular heart rate, usually over 150 bpm
Hypertension, High cholesterol & Diabetes. Smoking and weight control. -
ANS-Modifiable hypertensive risk factors
List lifestyle factors which reduce hypertension - ANS-Maintain healthy body weight.
Reduce fatty foods. Be physically active.
Hypertension - ANS-abnormally high blood pressure
Pathophysiology of hypertension - ANS-- Excessive blood volume (Puts high pressure
on vessel walls)
- Excessive constriction of arteries (Smooth muscle cells around arteries contracted)
...Or combination of both
Hypertension and what RAAS has to do with it - ANS-RAAS is the signalling pathway to
regulate blood pressure.
Define the RAAS System: - ANS-Renin is released if there is a drop in BP. Which then
splits into Angiotensin 1, then converted by the angiotensin enzyme into Angiotensin 2 =
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