Cardiac Dyspnea Flashcards
HF dyspnea is related to… (3)
Increased LV end-diastolic pressure
Increased pulmonary capillary wedge pressure
Hypoxia from V/P mismatch
MCC of LV systolic dysfunction is:
IHD
S3 gallop
3rd heart sound
In adult, usually sign of failing ventricle (HF)
Cough in HF looks like…
Pink, frothy. From pulm capillaries.
Hepatomegaly is a sign of HF. What does it present/look like?
Venous congestion
RUQ tenderness
Increased LFTs
Altered coagulation states
ACC/AHA stages of HF
Stage A
At risk for HF (DM, HTN, vascular dz, metabolic syndrome, etc.) but NO current heart disease.
No symptoms.
1 year mortality = 5-10%
ACC/AHA stages of HF
Stage B
Structural heart disease (LVH, red EF, chamber hypertrophy, previous MI, etc.)
No symptoms.
1 year mortalitiy = 5-10%
ACC/AHA stages of HF
Stage C
Structural heart disease
HF symptoms currently or prior
1 year mortality = 15-30%
ACC/AHA stages of HF
Stage D
Refractory HF
Needs biventricular pacemaker, LVAD, transplant, etc.
1 year mortality = 50-60%
NYHA functional classification
Class I
No limitation of physical activity
ASX
1 year mortality = 5-10%
NYHA functional classification
Class II
Slight limitation in physical activity
Exertional SX with ordinary activity
No SX at rest
1 year mortality = 15-30%
NYHA functional classification
Class III
Marked limitations of physical activity
Less than ordinary activity causes SX
No SX at rest
1 year mortality = 15-30%
NYHA functional classification
Class IV
Unable to carry out physical activity w/o SX/discomfort
SX at rest*
1 year mortality = 50-60%
Systolic HF on exam (HFeEF)
EF < 40%, decreased SV, hypoperfusion
Weak, fatigued, dec exercise tolerance
DOE, orthopnea, PND, S3 gallop
50% of HF cases
Diastolic HF on exam (HFpEF)
Normal EF
Ventricles don’t relax, increased stiffness, resistance to filling, etc.
Assoc. with myocardial fibrosis, amyloidosis, ischemia, etc.
SOB, DOE, pulm edema
Causes of acute HF
Acute MI
Ruptured papillary m.
MR
AI/R
High output HF
Occurs in:
EF reduced, but high CO
Ex: hyperthyroidism, pregnancy, anemia, Beriberi, Paget’s disease, etc.
Low output HF occurs in:
IHD, HTN
DCM, Valvular/pericardial dz
How do tachy and brady rhythms lead to HF
Tach: decreased ventricular filling time, leading to ischemia
Brady: slow rate, leads to dec perfusion
HF Tx (non-pharm)
Immunize vs. pneumonia Avoid NSAIDs Reduce salt intake No smoking No EtOH
AHA diet
Watch calories, stimulants, salt
Stool softeners, Lovenox
Low flow O2
Treat DM, HTN, hyperlipidemia
