Acute Heart Failure AHF Flashcards
What is acute heart failure?
Acute heart failure is a sudden or rapid onset of symptoms and signs of heart failure, often requiring urgent medical attention.
What are the common causes of acute heart failure?
Causes include myocardial infarction, arrhythmias, valvular heart disease, infection, non-compliance with medications, and hypertensive crisis.
How is acute heart failure classified?
It is classified based on fluid status (wet or dry) and perfusion status (warm or cold).
What are the typical symptoms of acute heart failure?
Symptoms include breathlessness, orthopnoea, paroxysmal nocturnal dyspnoea, fatigue, and reduced exercise tolerance.
What are the common signs of acute heart failure on examination?
Signs include raised jugular venous pressure (JVP), peripheral oedema, pulmonary crackles, tachycardia, and hypotension.
What is the pathophysiology of acute heart failure?
It involves impaired cardiac output or increased filling pressures, leading to pulmonary congestion and systemic hypoperfusion.
What are the risk factors for developing acute heart failure?
Risk factors include coronary artery disease, hypertension, diabetes, atrial fibrillation, and pre-existing chronic heart failure.
How is acute heart failure diagnosed?
Diagnosis is based on clinical features, supported by investigations like ECG, echocardiography, chest X-ray, and blood tests.
What investigations are performed in acute heart failure?
ECG, chest X-ray, blood tests (e.g., BNP/NT-proBNP, renal function), and echocardiography.
What are the chest X-ray findings in acute heart failure?
Findings may include cardiomegaly, pulmonary oedema, Kerley B lines, pleural effusions, and vascular redistribution.
What is the role of BNP or NT-proBNP in diagnosing acute heart failure?
Elevated levels suggest increased cardiac wall stress and help differentiate heart failure from other causes of breathlessness.
What are the clinical features of pulmonary oedema in acute heart failure?
Severe dyspnoea, orthopnoea, pink frothy sputum, tachypnoea, and crackles on auscultation.
What are the differential diagnoses for acute heart failure?
Differential diagnoses include pneumonia, pulmonary embolism, COPD exacerbation, and acute kidney injury.
What are the immediate management priorities in acute heart failure?
Priorities include oxygen therapy, diuretics, vasodilators, and addressing underlying causes.
What is the role of diuretics in managing acute heart failure?
Diuretics, such as intravenous furosemide, relieve symptoms by reducing fluid overload.
When are vasodilators used in acute heart failure?
Vasodilators like nitrates are used to reduce preload and afterload in patients with pulmonary congestion and normal or high blood pressure.
How is hypotension managed in acute heart failure?
Hypotension may require inotropes like dobutamine or noradrenaline to improve cardiac output and maintain perfusion.
What is the role of non-invasive ventilation (NIV) in acute heart failure?
NIV, such as CPAP or BiPAP, improves oxygenation and reduces work of breathing in pulmonary oedema.
What are the complications of untreated acute heart failure?
Complications include multi-organ failure, cardiogenic shock, arrhythmias, and death.
How is cardiogenic shock related to acute heart failure?
Cardiogenic shock occurs when severe cardiac dysfunction leads to inadequate tissue perfusion, a life-threatening complication of acute heart failure.
What lifestyle advice should be given to patients after acute heart failure?
Avoid excessive salt and fluid intake, adhere to prescribed medications, monitor weight daily, and report worsening symptoms promptly.
What is the long-term management of acute heart failure?
Optimising treatment for underlying causes, managing comorbidities, regular follow-up, and initiating guideline-directed medical therapy.
What is the role of echocardiography in acute heart failure?
Echocardiography assesses ejection fraction, wall motion abnormalities, and structural heart disease, guiding management.
What medications are typically continued or initiated after stabilisation of acute heart failure?
ACE inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and diuretics as indicated.
