cardio Flashcards
Impact of CHF right
weight gain, edema, ascites
impact of CHF left
nocturnal cough, gasping at night, orthopnea, wheezes (pulmonary edema)
need to ask for differential diagnosis cause of CHF
MD
Medications
C - change
A additionals
R - regularly taking
D - dose changes/ digoxin
diet
c- change in diet
a- additional salt / additional fluids
r- regular monitoring of salt
nyha classification
class
1 - ordinary activity does not case chf
2 - comfortable at rest , ordinary acitivity causes symptoms
3 - marked limitation on ordinary activity
4 - inability to carry out ordinary activity
chest findings CHF
increased pulmonary vascular marking
kerley B lines
cardiomegaly
small bilateral pleural effusions
bilateral interstitial infiltrates
treatment acute CHF
L - lasix 40-500mg TIV - dec preload
M- morphine 2-4mg decrease anxiety
N - nitrates increase kidney perfusion
O - oxygen
P- positive airway pressure decrease preload
P - position with legs hanging
CHF long term treatment
A - ACEI / ARBS
B - beta blockers - titrate may initially worsen CHF
C -
D- digoxin
D - diuretics furosemide 80mg OD
Spironolactone class II B and IV CHF already on Loop and ACE
still uncompensated - implantable cardioverter defibillator
Anti arrythmic drugs - amiodarone, beta blocker, digoxin
anti coagulants - warfarin
Digoxin overdse
Nausea/ vomiting
E- yellow halos around objects
Bradycardia, dizziness, LOC
ECG - PVC heart block
CHF differential diagnosis if with fever
bacterial endocarditis
CHF case DD if sudden symptoms
cardiac tamponade / acs
Heart racing problem trigger factors
ACCCC SAD
anxiety
chocolate
coke
caffeine
coccaine
smoking
alcohol
medications causing heart racing problem
beta blockers
stimulants
pseudophedrines
Heart racing problem DD
hyperthyroidism
pheochromocytoma
heart racing case worrisome problems
CVA. heart failure, V fib
causes of AF
IHD
hypertension/ CHF
medications
electrolyte imbalance
too much alcohol - holiday heart
cardiomyopathy
