Cardiovascular system
David A Lisle in Imaging for Students, 2012
Dyspnoea may have a variety of causes including cardiac and respiratory diseases, anaemia and anxiety states. Certain features in the clinical history may be helpful in diagnosis, such as whether dyspnoea is acute or chronic, worse at night, or accentuated by lying down (orthopnoea). Initial tests include full blood count, ECG and CXR, followed by pulmonary function tests when a respiratory cause such as emphysema or asthma is suspected. Congestive cardiac failure (CCF) is the most common cardiac cause of dyspnoea. CCF may be caused by systolic or diastolic dysfunction, or a combination of the two. Systolic dysfunction refers to reduction of the amount of blood pumped due to failure of ventricular contraction. Diastolic dysfunction refers to failure of ventricular relaxation between contractions leading to reduced filling of the ventricular chambers.
The left ventricle and its systolic function
Andrew R. Houghton in MAKING SENSE of Echocardiography, 2013
There are many causes of systolic heart failure, including: coronary artery diseasehypertensionvalvular diseaseviral myocarditiscardiomyopathy (Chapter 24)cardiotoxic drugs e.g. anthracyclinesalcohol.
Neuroendocrine disease
Philip E. Harris, Pierre-Marc G. Bouloux in Endocrinology in Clinical Practice, 2014
Cardiomyopathy is a hallmark of acromegaly and is characterized by biventricular hypertrophy, exacerbated by concomitant hypertension. Over a period of time, diastolic and systolic dysfunction develops. In a retrospective study using Doppler echocardiography in 205 patients with active acromegaly compared with age- and sex-matched nonacromegalic control subjects, the relative risk of developing left ventricular hypertrophy (LVH) was at least 11.9 times higher in the acromegalic patients. Disease duration was found to be the most important criterion for the prevalence and severity of cardiomyopathy. Patients with disease activity of 10 years or more had a threefold higher average relative risk of LVH, associated with diastolic and systolic dysfunction, compared with patients with shorter disease duration. This study also demonstrated an ~1.7-fold increased risk of hypertension and a 4.9-fold increased risk of cardiac arrhythmias.122 There is an increased prevalence of concomitant valvular heart disease, represented by thickening of the aortic and mitral valves, and resulting in aortic and mitral regurgitation.123,124
Peak V’O2 is an independent predictor of survival in patients with cardiac amyloidosis
Published in Amyloid, 2018
Selina Hein, Fabian Aus Dem Siepen, Ralf Bauer, Hugo A. Katus, Arnt V. Kristen
In contrast to peak V’O2 calculation, ventilatory efficacy, indicated by V’E/V’CO2 slope, can even be determined in the absence of maximal test conditions. The V’E/V’CO2 slope provided greater prognostic discrimination in all RER subgroups than peak V’O2 [25] and was a valuable predictor of prognosis in systolic heart failure [6,26]. Hence, it was closely related to outcome of advanced systolic heart failure [20,27] and ultimately more powerful to predict mortality than peak V’O2 [28,29]. Myers et al. [20] revealed in an extensive cohort of 2625 patients with chronic heart failure V’E/V’CO2 slope as the most powerful noninvasive predictor of mortality compared to peak V’O2, abnormal heart rate recovery, oxygen uptake efficiency slope, and end-tidal CO2 pressure. However, this was not supported by the present study as peak V’O2 was the only independent predictor of mortality by CPET but not V’E/V’CO2 slope. This might be explained by heart failure due to diastolic dysfunction in patients of this study.
Obesity related changes in cardiac structure and function: role of blood pressure and metabolic abnormalities
Published in Acta Cardiologica, 2020
Tiziana Di Chiara, Antonino Tuttolomondo, Gaspare Parrinello, Daniela Colomba, Antonio Pinto, Rosario Scaglione
In addition, left ventricular dysfunction found in the present study in obese patients with LVH has been reported by us previously in healthy young obese subjects [33,34]. Factors contributing to LV systolic dysfunction in obesity include adverse LV loading conditions, duration of obesity, increased LV mass, and perhaps most importantly, co-morbidities such as CAD, hypertension and diabetes mellitus. In addition, it is well known that adiponectin and other ADKs may influence the relation between obesity and LV systolic function [8,11,14,26,27]. Recent data by Wu et al. [35] further support our results clearly indicating that obesity is able to predict a greater longitudinal increase in LVMI and decrease in LVEF in diabetic patients compared with overweight or normal weight subjects. Other studies utilising tissue Doppler and strain imaging technology have shown respectively a negative correlation between systolic parameters and severity of obesity and a reduced global longitudinal LV strain and strain rate in obese subjects [36,37]. These studies were performed in asymptomatic patients and this suggests that load-independent sub-clinical LV systolic dysfunction may be more common in obese subjects than was previously realised [35–37].
Heart failure in congenital heart disease: management options and clinical challenges
Published in Expert Review of Cardiovascular Therapy, 2020
Elsbeth M. Leusveld, Robert M. Kauling, Laurie W. Geenen, Jolien W. Roos-Hesselink
Symptoms and signs are often nonspecific and can be different from heart failure symptoms in the general population due to the relatively younger age and more complex (cardiac) history of the ACHD population, including a higher percentage of right heart failure [31]. Symptoms of heart failure include, but are not limited to, shortness of breath, fatigue, loss of energy, orthopnea, palpitations, postural nocturnal dyspnea, diminished exercise capacity, loss of appetite, weight gain, swollen ankles or abdomen, and chest discomfort. A thorough history should be taken to elucidate the nature of the symptoms, time frame, provoking factors, such as anemia, arrhythmias, or substance abuse, and alternative explanations. The aim of the physical examination should be focused on signs of congestion and should be repeated at regular intervals during follow-up and treatment.
Related Knowledge Centers
- Angina
- Chest Pain
- Exercise Intolerance
- Fatigue
- Paroxysmal Nocturnal Dyspnoea
- Peripheral Edema
- Shortness of Breath
- Syndrome
- Orthopnea
- Signs & Symptoms
- Shortness of Breath