acute LV failure Flashcards
1
Q
acute LVF - presentation on inspection
A
"this pt would look unwell" - pale + grey bloodstained + frothy sputum in pot accessory muscles - orthopnoea wheeze cold clammy peripheries - cyanosis
2
Q
acute LVF - signs
A
sinus tachy / AF BP can be low, normal, high raised JVP cardiomegaly - displaced apex, valve disease signs HS3/4 pleural effusion
3
Q
acute LVF - initial investigations
A
GOUGE - DM; hypoxaemia + resp acidosis; arrhythmia, heart block, ischaemia, VH
BNP (raised confirms diagnosis)
troponin (infarct)
echo in 48h - LVEF, valvular disease
CXR
FBC - ?anaemia, ?infection
U+E+C - ?RF, ?derangement. monitor renal function + electrolytes with diuretics
4
Q
acute LVF - causes
A
CHAMPS Coronary syndrome HTive emergency Arrhythmia Mechanical eg acute valve leak, VSD, LV aneurysm PE Sepsis
5
Q
acute LVF - treatment
A
call senior + consider early ICU review
A - sit pt up
B - hi flow oxygen 15L/min via nonrebreathe
C - IV vasodilators (GTN/isosorbide infusion) if SBP > 90
D - IV furosemide 40mg
E - ?inotropes eg dobutamine if SBP <90
?ITU w CPAP if no improvement/resp acidosis