Acute LVF and pulmonary oedema Flashcards
What is acute left ventricular failure?
left ventricle is unable to adequately move blood through left side of heart
backlog of blood that increases volume in left atrium, pulmonary veins and lungs
pulmonary oedema
lung tissues and alveoli become full of interstitial fluid
SOB, oxygen desaturation
triggers of acute LVF
iatrogenic eg IV fluids
sepsis
MI
arrythmias
presentation of acute LVF
rapid onset SOB
worse lying flat
improve sitting up
type 1 resp failure = low oxygen with no increase Co2
symptoms
SOB
Cough - frothy white/pink sputum
on examination
increased resp rate
reduced oxygen sats
tachycardic, 3rd heart sound, bilateral basal crackles
what signs would be found if they also have right sided heart failure?
raised JVP
peripheral oedema
Investigations
ECG
ABG
CXR
Bloods - BNP, infection, kidney function, troponin
BNP - when is it released?
from ventricles when myocardium is stretched
high BNP?
heart is overloaded with blood and cannot pump effectively
action of BNP
relax smooth muscle in blood vessels to reduce resistance
diuretic to promote excretion
Other causes of raised BNP
sepsis tachycardia PE renal impairment COPD
Main measure of left ventricle - echo
ejection fraction
what is the ejection fraction?
percentage of blood in left ventricle squeezed out with each ventricular contraction
above 50% is normal
cardiomegaly on CXR
cardiothoracic ratio >0.5
