cardiology <3questions and answers Graded
A+
clinical syndrome resulting from either a structural or functional disorder of the
heart, leading to inability of the heart to pump sufficient blood to meet the
metabolic demands of the body at normal filling pressures
heart failure
MC predisposing factor to heart failure (in general)
CAD
EF values for the following:
HFrEF
HFmrEF
HFpEF
HFrEF: <40%
HFmrEF: 40-50%
HFpEF: >50%
systolic or diastolic HF:
pumping problem due to weakened, thin, or overly compliant ventricles
systolic HF
systolic HF is associated with ______ (reduced/normal) EF and a _____ (S3/S4)
gallop
reduced; S3
another name for systolic heart failure
HF with reduced EF (HFrEF)
MC etiology of systolic HF
post MI
,cardiomyocyte death -> thinning of ventricles bc muscle has broken down
others: DCM, valvular disease (esp AS)
what causes the S3 gallop in systolic HF
rapid filling of a dilated ventricle
another name for diastolic HF
HF with preserved EF (HFpEF)
systolic or diastolic HF:
filling problem due to stiffened, thickened ventricles
diastolic HF
MC etiology of diastolic HF
long-standing HTN (elderly)
heart has to pump super hard to get through hypertensive vessels -> muscle gets
stronger to compensate
others: valvular heart disease (esp AS), restrictive and hypertrophic CM
diastolic HF is associated with ______ (reduced/normal) EF and a _____ (S3/S4)
gallop
normal or increased; S4
what causes the S4 gallop heard in diastolic HF
atrial contraction of blood into a stiff, noncompliant ventricle
MC etiologies of left-sided HF (3)
CAD (MCC), HTN, valvular disease
clinical manifestations of left-sided HF
pulmonary symptoms:
- dyspnea (MC)
- orthopnea
,- exercise intolerance, fatigue
- cough: nonproductive OR pink frothy sputum
MC symptom seen in left-sided HF
dyspnea
what lung sound may be heard in left-sided HF
rales (crackles)
*due to lungs filling with fluid
what PE finding may be seen in advanced left-sided HF
cheyne-stokes breathing: deeper, faster breathing with gradual decrease and
periods of apnea
MC etiologies of right-sided HF (2)
left sided HF (MCC), pulmonary disease (COPD, PHTN)
**MC cause of right-sided HF
left-sided HF
clinical manifestations of right-sided HF
systemic symptoms
- peripheral edema (pitting)
- JVD
- GI and hepatic congestion: N/V, abdominal bloating, hepatojugular reflux
what is hepatojugular reflux
increased JVD with liver palpation
*seen in right-sided HF
systolic or diastolic HF:
- weakened, thin or overly compliant ventricles
, - decreased EF
- S3 heard on auscultation
systolic (HFrEF)
systolic or diastolic HF:
- stiffened, thick or noncompliant ventricles
- normal EF (or increased)
- S4 heard on auscultation
diastolic (HFpEF)
right or left sided HF:
- fluid backs up into the lungs via the pulmonary vein
- dyspnea MC symptoms, also pulmonary edema, congestion, orthopnea
- commonly caused by CAD, HTN
left-sided HF
[Left = lungs]
right or left sided HF:
- fluid backs up into the IVC, SVC, and hepatic circulation
- peripheral edema, JVD, hepatic congestion, hepatojugular reflux
- commonly caused pulmonary disorders, but the MCC is left-sided HF
right-sided HF
[Right = Rest of the body]
NYHA Functional Classification
no symptoms, no limitation during ordinary physical activity
class I
NYHA Functional Classification
A+
clinical syndrome resulting from either a structural or functional disorder of the
heart, leading to inability of the heart to pump sufficient blood to meet the
metabolic demands of the body at normal filling pressures
heart failure
MC predisposing factor to heart failure (in general)
CAD
EF values for the following:
HFrEF
HFmrEF
HFpEF
HFrEF: <40%
HFmrEF: 40-50%
HFpEF: >50%
systolic or diastolic HF:
pumping problem due to weakened, thin, or overly compliant ventricles
systolic HF
systolic HF is associated with ______ (reduced/normal) EF and a _____ (S3/S4)
gallop
reduced; S3
another name for systolic heart failure
HF with reduced EF (HFrEF)
MC etiology of systolic HF
post MI
,cardiomyocyte death -> thinning of ventricles bc muscle has broken down
others: DCM, valvular disease (esp AS)
what causes the S3 gallop in systolic HF
rapid filling of a dilated ventricle
another name for diastolic HF
HF with preserved EF (HFpEF)
systolic or diastolic HF:
filling problem due to stiffened, thickened ventricles
diastolic HF
MC etiology of diastolic HF
long-standing HTN (elderly)
heart has to pump super hard to get through hypertensive vessels -> muscle gets
stronger to compensate
others: valvular heart disease (esp AS), restrictive and hypertrophic CM
diastolic HF is associated with ______ (reduced/normal) EF and a _____ (S3/S4)
gallop
normal or increased; S4
what causes the S4 gallop heard in diastolic HF
atrial contraction of blood into a stiff, noncompliant ventricle
MC etiologies of left-sided HF (3)
CAD (MCC), HTN, valvular disease
clinical manifestations of left-sided HF
pulmonary symptoms:
- dyspnea (MC)
- orthopnea
,- exercise intolerance, fatigue
- cough: nonproductive OR pink frothy sputum
MC symptom seen in left-sided HF
dyspnea
what lung sound may be heard in left-sided HF
rales (crackles)
*due to lungs filling with fluid
what PE finding may be seen in advanced left-sided HF
cheyne-stokes breathing: deeper, faster breathing with gradual decrease and
periods of apnea
MC etiologies of right-sided HF (2)
left sided HF (MCC), pulmonary disease (COPD, PHTN)
**MC cause of right-sided HF
left-sided HF
clinical manifestations of right-sided HF
systemic symptoms
- peripheral edema (pitting)
- JVD
- GI and hepatic congestion: N/V, abdominal bloating, hepatojugular reflux
what is hepatojugular reflux
increased JVD with liver palpation
*seen in right-sided HF
systolic or diastolic HF:
- weakened, thin or overly compliant ventricles
, - decreased EF
- S3 heard on auscultation
systolic (HFrEF)
systolic or diastolic HF:
- stiffened, thick or noncompliant ventricles
- normal EF (or increased)
- S4 heard on auscultation
diastolic (HFpEF)
right or left sided HF:
- fluid backs up into the lungs via the pulmonary vein
- dyspnea MC symptoms, also pulmonary edema, congestion, orthopnea
- commonly caused by CAD, HTN
left-sided HF
[Left = lungs]
right or left sided HF:
- fluid backs up into the IVC, SVC, and hepatic circulation
- peripheral edema, JVD, hepatic congestion, hepatojugular reflux
- commonly caused pulmonary disorders, but the MCC is left-sided HF
right-sided HF
[Right = Rest of the body]
NYHA Functional Classification
no symptoms, no limitation during ordinary physical activity
class I
NYHA Functional Classification
