Acute LVF and Pulmonary Oedema

Question 1

Acute Left Ventricular Failure

Answer 1

• left ventricle can’t move blood
• backlog of blood –> stuck in the left atrium, pulmonary veins, lungs
• pul oedema
• alveoli fill with interstitial fluid and impair gas exchange

Question 2

Acute Left Ventricular Failure - triggers

Answer 2

• iatrogenic
• sepsis
• MI
• arrhythmias

Question 3

Acute Left Ventricular Failure - presentation

Answer 3

rapid onset breathlessness
- exacerbated by lying flat and improves on sitting up
Symptoms
- SOB
- cough (frothy sputum)

Question 4

Acute Left Ventricular Failure - examination

Answer 4

• increased resp rate
• reduced O2 stats
• tachycardia
• 3rd heart sound

Question 5

Acute Left Ventricular Failure - symptoms with right-sided heart failure

Answer 5

• raised jugular venous pressure
• peripheral oedema

Question 6

Acute Left Ventricular Failure - BNP MOA

Answer 6

• B- type natriuretic peptide - released from heart ventricles when they are stretched beyond the normal range
• relaxes smooth muscle
• reduces systemic vascular resistance

Question 7

Acute Left Ventricular Failure - causes of raised BNP

Answer 7

• heart failure
• tachycardia
• sepsis
• PE
• renal impairment
• COPD

Question 8

Acute Left Ventricular Failure -Echocardiography

Answer 8

• measure ejection fraction
• % of blood ventricular contraction
• > 50% if normal

Question 9

Acute Left Ventricular Failure -management

Answer 9

• Pour away (stop fluids)
• Sit up
• Oxygen
• Diuretics (furosemide 40mg)