Acute Cardiac Failure Flashcards

1
Q

Define acute cardiac failure.

A

Heart failure is defined clinically as a syndrome in which patients have symptoms and signs resulting from an abnormality of cardiac structure and/or function. Acute heart failure refers to rapid onset or worsening of symptoms and/or signs of heart failure, requiring urgent evaluation and treatment.

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2
Q

Explain the aetiology/risk factors of acute cardiac failure.

A

Decompensation of pre-existing chronic heart failure
Other heart conditions such as aortic regurgitation
Lack of compliance with medical treatment
Volume overload
Infections
Severe brain insult
After major surgery
Reduction of renal function
Drug abuse
Phaeochromocytoma
High output syndromes (Septicaemia, Thyrotoxic crisis, Anaemia, Shunt syndromes)

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3
Q

Summarise the epidemiology of acute cardiac failure.

A

Heart failure is the most common indication for hospitalisation in the US, and acute decompensated heart failure is the most common cause for hospitalisation among patients >65 years.
The average age of people with heart failure in studies conducted in Europe is also older than 70 years, with slight predominance of men.

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4
Q

Recognise the presenting symptoms of acute cardiac failure.

A

Dyspnoea
Decreased exercise tolerance
Swelling of the legs
Fatigue
Generalised weakness

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5
Q

Recognise the signs of acute cardiac failure on physical examination.

A

Reduced cardiac output
Tissue hypoperfusion
Increased pulmonary pressure
Tissue congestion
Raised JVP

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6
Q

Identify appropriate investigations for acute cardiac failure and interpret the results.

A

ECG
Echocardiogram
CXR
Hb
TFT
Troponin
B-type natriuretic peptide (BNP)

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7
Q

Generate a management plan for acute cardiac failure.

A

Loop diuretic in order to get rid of oedema, and then ACEi after the patient stabilises.
Treatment is generally with ACEi and beta blockers.

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8
Q

Identify the possible complications of acute cardiac failure and its management.

A

ARRHYTHMIAS
Hypotension, hyperkalaemia and headaches may result from treatment.

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9
Q

Summarise the prognosis for patients with acute cardiac failure.

A

In hospital, mortality ranges from 2% to 20% depending on clinical factors found on admission.
Predictors of adverse outcomes include: hypotension, renal dysfunction, older age, male sex, ischaemic congestive heart failure (CHF), previous CHF, respiratory rate on admission >30/minute, anaemia, hyponatraemia, elevated troponin, elevated B-type natriuretic peptide, and other comorbidities such as cancer.

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