Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine > Approach to the patient with heart failure > Flashcards

Approach to the patient with heart failure Flashcards

Clinical findings Chest xray features Causes and patho-physiology: factors affecting pre-load, after-load and contractility Approach to treatment based on patho-physiology: diuretics, ACE inhibitors, beta blockers, spironolactone, digoxin

1
Q

Definition of heart failure?

A

Cardiac output insufficient to meet tissue perfusion needs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Causes of LV heart failure?

A

MI, ischaemic heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of RV HF?

A

LVF, pulmonary stenosis, pulmonary hypertension (PE, COPD, congenital, autoimmune diseases)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Definition and causes of systolic HF?

A

Reduced EF, inability of ventricle to contract normally

Causes: IHD, MI, cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Definition and causes of diastolic HF?

A 
Preserved EF, inability of ventricle to fill normally
Ventricular hypertrophy
Tamponade
Constrictive pericarditis
Restrictive cardiomyopathy
Obesity
Amyloidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Symptoms of LV HF?

A 
Reduced exercise tolerance
PND
Orthopnea (ask about pillows)
Fatigue
Nocturnal cough (pink/frothy sputum)
Nocturia
Cold peripheries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Signs of LV HF?

A

Reduced peripheral perfusion
Narrow pulse pressure
Tachypnoea + tachycardia
Displaced apex beat
Third heart sound (stiffened ventricle, gallop)
Bibasal fine inspiratory crackles in lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Symptoms of RV HF?

A 
Peripheral oedema
Ascites
Nausea
Anorexia
Facial engorgement (venous congestion)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Signs of RV HF?

A

Pulmonary heave
Hepatosplenomegaly
Increased JVP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Causes of excessive preload?

A

Fluid overload
Mitral regurgitation
Increases muscle length –> Starling’s law

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Causes of reduced contractility?

A 
Ventricular hypertrophy
Cardiomyopathy
MI/IHD
Heart block
Negative inotropes/beta blockade
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Causes of increased afterload?

A

Aortic stenosis
Hypertension
Increased muscle stiffness + reduced filling due to thickening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Causes of high-output cardiac failure?

A

Hyperthyroidism
Anaemia
Pregnancy
Paget’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do you investigate heart failure?

A 
B: FBC, U+E, BNP
O: N/A
X: CXR
E: ECG, echocardiogram
S: N/A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

CXR features of CCF?

A 
A: Alveolar oedema (bat wing)
B: Kerley B lines
C: Cardiomegaly
D: Dilated upper lobe vessels
E: Pleural effusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment for HF?

A

ACE-i: Causes dry cough and hyperkalaemia
Beta blocker:
Diuretics: Furosemide to relieve symptoms. Spironolocatone to reduce mortality/manage diuretic-induce hypokalaemia
Digoxin: Positive inotrope, exacerbates hypokalaemia toxicity

Medicine (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions