2.04 - Management Of Heart Failure Flashcards
What is the European Task Force on Heart Failure definition for Heart Failure?
A syndrome in which the patients should have the following features: symptoms of heart failure, typically breathlessness or fatigue, either at rest of during exertion, or ankle swelling and objective evidence of cardiac dysfunction at rest”
What are the four stages of heart failure?
A: When there is no structural abnormalities in the heart but the patient has predisposing risk factors, such as diabetes and high BP
B: Pre-clinical, asymptomatic. Structural and functional decline by no symptoms
C: When the condition becomes clinically apparent
D: Where the symptoms remain despite full pharmacological therapy
Describe the timeline of the progress of heart failure
1: Diagnosis of heart failure
2: Patients that respond to treatment
3: Become unstable, increased symptoms, have to increase treatment
4: Patient fails to respond to treatment, end of life discussions should ideally begin here
5: Failure of all treatments, end of life discussion and ultimately death
What are the common risk factors for development of heart failure?
Advanced age (>60yrs)
Low physical activity
Cigarette smoking
Overweight
Hypertension
Diabetes
Valvular heart disease
Coronary artery disease
LV Hypertrophy
Family history and cardiomyopathy
Atrial fibrillation
Hyperlipidaemia
Family history
What would you discover on physical examination of a patient with Heart Failure?
Pulse rate and rhythm dysregulation
Elevated blood pressure
Elevated JVP
Cardiomegaly
Cardiac Murmurs
Lung crepitations
Hepatomegaly
Oedma
What investigtions would you order for a patient with suspected heart failure?
Echocardiogram
Electrocardiogram
Chest X-ray
What non-pharmacological management strategies are useful in heart failure
Physical activity, weight loss, smoking cessation, fluid restriction, reduce dietary sodium,
What are the first line pharmacological treatments for heart failure?
ACE Inhibitors
Beta blockers
AT1R antagonists (for those who cant tolerate ACEI)
Diuretics
Spironolactone
