040715 dyspnea Flashcards
causes of heart failure
HTN
valvular
ischemia
cardiomyopathy
for reduced ejection fraction heart failure, what drugs have shown a decrease in mortality
beta-SA:
beta blocker
spironolactone
ACE inhibitor or ARB
ECHO can be used to look at what for heart
size of ventricles, atria
for valvular stenosis, regurg
for systolic function
side effects of ACE inhibitors
cough
angioedema
hyperkalemia
orthostatic hypotension
causes of dyspnea
pulmonary (COPD, asthma, infection, pneumothorax)
cardiac (heart failure, MI, arrhythmia, valvular disorder, cardiac tamponade)
neuro/musculosk (ALS, myasthenia gravis, rib fracture)
hematologic (anemia, pulmonary embolism)
upper airway (angioedema, anaphylaxis, foreign body)
toxic/metabolic (metabolic acidosis, poisoning by CO or salicylate)
preserved EF causes of heart failure
HTN
aging
restrictive cardiomyopathy (hemochromatosis)
infiltrative (amyloidosis, sarcoidosis)
reduced EF causes of heart failure
coronary artery disease/MI HTN toxins (alcohol, doxorubicin, cocaine) viral idiopathic
what diagnostic tests would you do for heart failure?
EKG (arrythmias, MI)
CXR (cardiomegaly)
ECHO
what provides immediate symptom relief of dyspnea caused by heart failure
furosemide
arteriolar dilators
hydralazine
minoxidil
calcium channel blockers
venodilators
nitrates
a fib can be treated w
diltiazem
which drug regimen has been shown to reduce mortality in heart failure w preserved EF?
none
which drug regimen has been shown to reduce mortality in heart failure w reduced EF?
beta blockers
spironolactone
ACE/ARBs
biggest risks of furosemide
hypokalemia, hyperuricemia
tx for a fib
control rate-diltiazem
prevent stroke-warfarin
prevent or improve CHF-furosemide
what test to diagnose PE?
calculate Wells score and get D-dimer. if score is above 4, should do CT angiography
chest CT
acute tx of PE?
heparin (unfractionated)
fondaparinux
enoxaparin (LMWH)
tPA
what are advantages of new ORAL anticoags (rivaroxaban, dabigatran) over warfarin
rapid onset of action absence of food interactions fewer strong drug interactions wide therapeutic window fewer adverse effects lower risk of intracranial hemorrhage
long term management for PE
warfarin
rivaroxaban
dabigatran