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Cardiovascular > Cardiac failure > Flashcards

Cardiac failure Flashcards

1
Q

Causes of heart failure (4)

A

Ischaemic heart disease, valvular heart disease, hypertension and cardiomyopathy

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2
Q

Precipitants of heart failure (4)

A

Infarction, arrhythmia, infection, anaemia

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3
Q

Pathophysiology of heart failure (vicious cycle!)

A

Inadequate cardiac output –> compensatory increase in TPR to maintain blood pressure –> harder for heart to pump

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4
Q

Two types of heart failure, their alternate names, how they are defined in terms of ejection fraction % and the percentage of patients affected.

A
  1. HFREF (systolic) - ejection fraction less than 40%, 70% patients
  2. HFPEF (disastolic) - ejection fraction more than 40%, 30% patients (mostly older females).
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5
Q

Causes of diastolic heart failure (3)

A

Hypertensive, restrictive cardiomyopathy, cardiac tamponade

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6
Q

Normal ejection fraction

A

55-70%

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7
Q

Symptoms of left ventricular failure (4)

A

Exertional dyspnoea, orthopnoea, paroxysmal nocturnal dyspnoea, fatigue

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8
Q

Signs of left ventricular failure (4)

A

Laterally displaced apex beat, bibasal lung crackles, LV S3 heart sound, central and peripheral cyanosis

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9
Q

Symptoms of right ventricular failure (4)

A

Swelling around ankles/back/abdomen, anorexia, nausea, fatigue

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10
Q

Signs of right ventricular failure (7)

A

Raised JVP, peripheral (pitting) oedema, ascites, tender hepatomegaly, RV S3 heart sound, heaves, peripheral cyanosis

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11
Q

NYHA classification (severity)

A
  1. No limitation of physical activity 2. Angina/dyspnoea on moderate activity 3. “ “ on mild activity 4. “ “ at rest
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12
Q

Important investigations in heart failure

A

ECG, CXR, TTE/TOE (Bloods: FBE, UEC, LFT, TSH, BNP)

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13
Q

Signs of heart failure on chest x-ray

A

Alveolar oedema, kerley B lines, cardiomegaly, upper lobe diversion, pleural effusion (bat wing sign)

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14
Q

Acute management of heart failure

A

LMNOPP Lasix (frusemide) Morphine Nitroglycerin Oxygen (if hypoxic) Positive airway pressure Positioning

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15
Q

Chronic management of heart failure (according to NYHA classification)

A

ABcDD

I: ACE inhibitors/ARBs

II: add beta blockers

III: add diuretic (spironolactone)

IV: add digoxin

+ lifestyle, pacemaker/defib/transplant

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16
Q

Which drug does not have mortality benefit in heart failure?

A

ARBs

17
Q

Causes/precipitants of APO

A

(MAD HATTER) -Myocardial infarction -Anaemia -Dietary, drugs -Hypertension -Arrhythmias -Thyrotoxicosis -Toxins, infections -Embolism, endocarditis -Renal failure, ruptured placenta, pregnancy

Cardiovascular (14 decks)

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