B4.019 Congestive Heart Failure: A Clinical Case Flashcards
signs of decompensation in heart failure
rapid HR new afib hypotension hypoxia fluid overload decrease renal output severe exercise intolerance high levels of BNP acute coronary syndrome
heart failure epidemiology
lifetime risk 20% for people over 40
>650,000 new cases per year
20/1000 age 65-69
>80/1000 age 85 and older
% of people with HFpEF
almost 50%
risk factors for heart failure
older age female sex obesity hypertension tobacco use diabetes CAD valvular heart disease a-fib
what is HErEF
heart failure with reduced ejection fraction
EF < 40%
systolic HF
efficacious therapies exist
what is HEpEF
heart failure with preserved ejection fraction
EF > 50%
diastolic EF
no efficacious therapies available
what criteria are used to diagnose HF
Framingham Criteria
2 major or 1 major and 2 minor
major Framingham Criteria
acute pulmonary edema cardiomegaly hepatojugular reflex neck vein distention paroxysmal nocturnal dyspnea/orthopnea
minor Framingham Criteria
ankle edema dyspnea on exertion hepatomegaly nocturnal cough pleural effusion tachycardia
first interventions for HFpEF
diuretics mainstay rate control - B blocker HTN control- ACE inhib exercise control comorbidities
treatments for HFrEF
ACE or ARB b blockers aldosterone agents neprilysin inhibitor/ ARM therapy participation in HF management programs
diagnostic tests in HF
CBC CMP BNP >100 N-term pro-BNP >300 EKG CXR echocardiogram
stage A of HF
at high risk for HF but without structural heart disease or symptoms of HF
stage B of HF
structural heart disease but without signs or symptoms of HF
stage C of HF
structural heart disease with prior or current symptoms of HF
