Cardiac Failure Flashcards
1
Q
Define cardiac failure
A
Inability of cardiac output to meet body’s demands and perfuse the organs
2
Q
What are the causes/risk factors of cardiac failure?
A
Low output Right heart failure (lungs) • Infarction • Cardiomyopathy • Pulmonary hypertension • Pulmonary embolism • Chronic lung disease • Pulmonary valve disease • Tricuspid regurgitation • Constrictive pericarditis
Left heart failure (body) • Ischaemic heart disease • Hypertension • Dilated cardiomyopathy • Aortic valve disease • Mitral regurgitation
Congestive cardiac failure • Arrhythmia • Cardiomyopathy • Myocarditis • Drug toxicity
High output • Anaemia • Beriberi (thiamine deficiency) • Pregnancy • Paget’s disease • Hyperthyroidism • AV malformation
3
Q
What are the symptoms of cardiac failure?
A
Right (body) • Ankle swelling • Ascites • Fatigue • ↓ exercise tolerance
Left (lungs) • SOB • Orthopnoea • PND • Fatigue
Acute LVF • SOB • Cough • Wheeze • Pink frothy sputum
4
Q
What are the signs of cardiac failure?
A
Right (body) • Hepatomegaly (+ nutmeg liver) • Ascites • Sacral oedema • Peripheral oedema • Raised JVP
Left (lungs) • Bibasal crepitations • Tachycardia • Tachypnoea • Displaced apex beat • S3 gallop
5
Q
What investigations are carried out for cardiac failure?
A
• Bloods - FBC – anaemia - U&Es - LFTs – hepatic congestion (RHF) - TFTs – hyperthyroidism - BNP (90% sensitive) • CXR - A – Alveolar shadowing (batwings) - B – Kerly B lines - C – Cardiomegaly - D – upper lobe diversion - E – pleural effusion • ECG - Ischaemic changes - Arrhythmias - LVH • Echocardiogram - Ejection fraction - Cardiac shunts – ASD, VSD - Hypertrophy - Other – valvular disease
6
Q
What is the management for cardiac failure?
A
Acute • Sit up • 60-100% O2 • IV furosemide • GTN infusion
Chronic Medical • ACE-I (or ARBs) • Beta-blockers e.g. carvedilol • Spironolactone (or eplerenone) • Other e.g. hydralazine, nitrates, digoxin, diuretics, salt restriction
Surgical • Revascularisation for CAD • Cardiac resynchronisation (biventricular pacing) • Implantable cardiac defibrillator • Heart transplant
7
Q
What are the complications of cardiac failure?
A
- Respiratory failure
- Cardiogenic shock (dobutamine)
- Death
