Medicine Notes Cardiology Notes
Complete set of notes on Cardiology. COvering all the main conditions with pathophysiology, presenting symptoms, investigation and management. Includes relevant pharmacology. Clear headings and concise bullet points, including table summaries. ...
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Heart Failure
Failure of the heart to maintain an adequate perfusion of the tissues despite adequate filling pressure
Aetiology
Causes of LHF
Inadequate LV filling
Mitral stenosis
Pressure overload
Aortic stenosis
Hypertension
Volume overload
Aortic/mitral regurg.
High output HF
LV muscle disease
MI
Cardiomyopathy
Pathogenesis
Causes listed above lead to one or more of;
Myocyte loss
Increased afterload (pressure against which heart has to pump)
Volume overload
Heart responds to this ventricular remodeling = myocardial hypertrophy + ventricular dilation
Initially process is adaptive as it decreases wall stress and maintains cardiac output
Eventually
Decreased ventricular systolic function
Decreased CO
RAS activation
Salt and water retention
Increase in vasoconstrictors
Further damage
Classification
Systolic vs diastolic HF
Systolic = impaired contractility of myocardium
Diastolic = impaired relaxation of myocardium
LHF vs RHF
Left = symptoms of pulm. Vascular congestion e.g dyspnea, pulm. Oedema
Right = Symptoms of systemic vascular congestion e.g ascites, raised JVP
Low output vs High output
Low = inadequate output for tissue perfusion
High = output fails to meet increased needs (thyrotoxicosis, anaemia)
Clinical features
Left Heart Failure
Symptoms | Signs |
---|---|
Dyspnoea Orthopnea Paroxysmal nocturnal dyspneoa (PND) Nocturnal cough Cold peripheries Nocturia Fatigue | Mild
Severe
|
Right Heart Failure
Symptoms | Signs |
---|---|
Ankle swelling Ascites Nausea (gut oedema) Anorexia Epistaxis Pulsation in neck and face | Raised JVP Hepatomegaly Ascites Ankle oedema Skeletal muscle wasting |
NYHA classification of...
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Complete set of notes on Cardiology. COvering all the main conditions with pathophysiology, presenting symptoms, investigation and management. Includes relevant pharmacology. Clear headings and concise bullet points, including table summaries. ...
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