Acute LVF and Pulmonary Oedema Flashcards
What is LVF?
LV is unable to adequately move blood through the LHS of the heart and out into body= causing a blockage of blood and increasing the amount of blood stuck in the LA, pulmonary veins & lungs
How does pulmonary oedema arise from LVF?
Vessels are engorged with blood due to LV inadequately moving blood so increased volume and pressure, they therefor leak fluid and are unable to reabsorb fluid from surrounding tissues
Triggers of Acute LVF?
Iatrogenic
Sepsis
MI
Arrhythmias
Presentation of acute LVF?
Rapid onset of breathlessness exacerbated by lying flat
- SOB
- Look/feel unwell
- Cough + frothy white/pink sputum
Examination results of acute LVF?
Raised RR Decreased oxygen sats Tachycardia 3rd heart sound Bilateral crackles (sounding wet on auscultation) Hypotension
Symptoms from underlying causes of LVF?
Chest pain: in ACS
Fever: in sepsis
Palpitations: arrhythmias
RS heart failure presents with?
Raised JVP caused by RHS backlog= engorged jugular vein
Peripheral oedema in ankles, sacrum, legs
Work up for someone with acute LVF?
History Clinical exam ECG for arrhythmias ABG Echocardiogram Chest X-ray Routine bloods for infection/kidney function/BNP & poss troponin
If suspected acute LVF always wait for test results to confirm. True or False?
FALSE
If clinical presentation= Acute LVF initiate treatment before confirmation with BNP/echo as patient can deteriorate quickly
What is BNP?
Hormone released from ventricles when cardiac muscle is stretched beyond normal range
Action of BNP?
To relax smooth muscle in blood vessels | Reducing system vascular resistance | Easier for heart to pump blood
Also acts on kidneys as diuretic to promote excretion of fluid
BNP test is sensitive not specific. True or False?
True
-ve test rules out HF
+ve test doesn’t ensure HF= could be
-tachycardia, sepsis, PEmboli, Renal impairment, COPD
What does echocardiography mainly measure?
Ejection Fraction
(% of blood in LV that is squeezed out with each ventricular contraction)
Above 50% ejection fraction is normal
Chest x-ray findings of Acute LVF?
Cardiomegaly
Upper lobe venous diversion
What is upper lobe venous diversion?
-Looks like increased prominence & diameter of upper lobe vessels on chest x-ray
-Usually when standing erect the lower lobe has more blood and upper looks relatively small.
In LVF the back pressure means upper lobe veins fill with blood & become engorged
