Congestive Cardiac Failure (CCF)

Vocabulary practice flashcards covering the pathophysiology, clinical manifestations, compensatory mechanisms, diagnostic investigations, staging, and management of Congestive Cardiac Failure (CCF).

Congestive Cardiac Failure (CCF)

A complex clinical syndrome resulting from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood, making cardiac output ($CO = SV \times HR$) insufficient to meet the body's metabolic demands.

Stroke Volume Determinants

The three physiological factors determining the volume of blood pumped per contraction ($SV$): preload, afterload, and myocardial contractility.

Ejection Fraction (EF)

The fraction or amount of blood pumped from the ventricle in one heartbeat; an ejection fraction below $40\%$ indicates that the heart cannot supply adequate blood and oxygen to meet cellular metabolic needs.

Left-Sided Systolic Dysfunction (HFrEF)

Heart failure with a reduced ejection fraction ($EF < 40\%$) caused by impaired ventricular contraction and ejection due to loss of myocardial cells from ischaemia, infarction, cardiomyopathy, or inflammation; accounts for $70\%$ of heart failure cases.

Left-Sided Diastolic Dysfunction

Heart failure characterized by impaired myocardial relaxation and ventricular filling with a preserved ejection fraction ($EF > 40\%$), resulting from decreased ventricular compliance due to hypertrophic and cellular changes; accounts for $30\%$ of heart failure cases.

Cardiac Chamber Remodelling (Dilated vs. Hypertrophied)

Pathological structural changes of the heart: Panel A represents dilated heart chambers with enlarged atria and ventricles, whereas Panel B demonstrates hypertrophied heart chambers featuring thickened heart muscle.

Right-Sided Heart Failure

Failure of the right ventricle to pump blood forward into the pulmonary circulation, leading to chamber distension, blood accumulation in the systemic venous system, peripheral oedema, ascites, and hepatomegaly.

Frank–Starling Mechanism

A compensatory mechanism where increased stretch of cardiac muscle fibres increases contractile force to elevate cardiac output ($CO$), but becomes limited by overstretching and increases myocardial oxygen demand.

Neuroendocrine Response in CCF

A compensatory reflex activated by decreased cardiac output ($CO$) that triggers the sympathetic nervous system and catecholamine release, initially raising heart rate, blood pressure, and contractility at the cost of tachycardia, reduced filling time, and increased myocardial workload.

Renin–Angiotensin–Aldosterone System Activation

A compensatory cascade stimulated by decreased cardiac output and renal perfusion that leads to angiotensin production and aldosterone release from the adrenal cortex, causing vasoconstriction, elevated blood pressure, and fluid retention.

Mean Arterial Pressure (MAP)

The arterial pressure defined physiologically as the product of cardiac output ($CO$) and total peripheral resistance ($TPR$); when $CO$ declines in heart failure, $MAP$ drops and compromises tissue perfusion.

Orthopnoea

A symptom of left-sided heart failure characterized by the onset of shortness of breath when lying flat.

Paroxysmal Nocturnal Dyspnoea (PND)

Attacks of severe shortness of breath and coughing that typically occur during the night in individuals with left-sided heart failure.

BNP and NT-proBNP

Natriuretic peptide biomarkers released by the atria used to detect deterioration in cardiac pump function, with rising levels correlating directly with worsening heart failure.

Echocardiogram (ECHO)

A diagnostic ultrasound examination utilized to assess the structural integrity and mechanical pumping function of the myocardium.

Stage A Heart Failure

A classification stage designating patients who are at high risk of developing heart failure but currently have no structural heart disease or symptoms.

Stage B Heart Failure

A classification stage designating patients who have developed structural heart disease but have never manifested signs or symptoms of heart failure.

Stage C Heart Failure

A classification stage designating patients with structural heart disease accompanied by current or prior symptoms of heart failure.

Stage D Heart Failure

Advanced heart failure characterized by refractory symptoms at rest requiring specialized interventions such as inotropic therapy, mechanical circulatory support (VAD), transplantation, or hospice care.

Positive Inotropic Drugs

Pharmacological agents, such as dopamine, administered in heart failure to increase the force of myocardial contraction.