acutely decompensated HF Flashcards
what can cause decompensation in heart failure
sodium intake infection high bp anemia renal failure sleep apnea arrythmia
physical exam findings with respect to BP in heart failure patients can be
hyper or hypotensive
when do you consider inotropes in HF
wet and cold
- increased filling pressures and low perfusion
when do you consider vasodilators in HF
- wet and warm
- adequate perfusion but filling pressures are too high
what lab test can be used to assess HF
BNP -
heart failure likely if more than 500 pg/mL
most patients with signs of congestion have BNP of
> 500
- no role for it!
high yield test to check for decompensated HF
chest x ray
if a patient is in respiratory distress from decompensated Heart failure then you shoudl consider
PPV
how does positive pressure ventilation help in decompensated HF
- opens up airways
- decreases preload to LV
reduces work of breathing
drugs that improve hemodynamics and make people feel better
digoxin diuretics morphine vasodilators inotropes
how do you manage fluid overload or congestion
give diuretic - loop
IV furosemide causes pulmonary venodilation in
5-10 mins!
what should you be aware of when using morphine for treating decompensated HF
- respiratory depression and hypotension
how does digoxin mainly work
by increasing vagal tone - in patients with A fib
only use inotropes in patients who are
COLD - i.e. low Cardiac output
