Cardiovascular: Heart Failure Flashcards
What is heart failure?
When the cardiac output is incapable of meeting the metabolic demands of the body tissues
What is congestive heart failure and what type of disease is this?
Both left and right sides of the heart fail.
Chronic coronary syndrome.
What causes congestive heart failure?
Ischaemic heart disease - angina
Decline in function of heart muscle.
Valvular heart disease - rheumatic heart disease and calcific aortic stenosis
Pressure overload
Hypertension - pressure overload.
What drugs contribute/worsen to heart failure?
B blockers - reduce efficiency of the heart by reducing force of contraction and excitability of cardiac muscle.
Corticosteroids
Anticancer drugs
What side of the heart fails most commonly and why?
Left as it has the highest demands - supplies oxygenated blood to the whole body
A patient with problematic lungs is likely to have heart failure of what side?
Right sided failure.
Right side of the heart pumps blood to the lungs to get oxygenated - if lungs are defective more blood will have to be pumped to the lungs to meet the demands = more strain on the right side.
In terms of heart failure, what is the common pattern of failure?
Right side fails AFTER the left.
Once the left side fails, blood pressure in the lungs increases which increases the demands of the right side = failure.
What are the signs and symptoms of heart failure dependant upon?
Which side fails.
What are the signs and symptoms of left sided heart failure?
Dyspnoea from oedema of the lungs
Tachycardia
Low blood pressure
What are the signs and symptoms of right sided heart failure?
Peripheral oedema
Poor absorption from the GIT
Hepatomegaly
What is the treatment for acute heart failure?
Hospitalisation;
Oxygen
Morphine
Frusemide - diuretic to increase fluid removal which reduces circulating volume which reduces strain on the failing heart.
What is the treatment for chronic heart failure?
Treat underlying cause
Treat with drug therapy:
DO NOT GIVE BETA BLOCKERS!!!!
ACE inhibitors e.g. enalapril
Nitrates e.g Isosorbide
Diuretics e.g frusemide or bendroflumethiazide
Inotropes (alter force of contraction of cardiac muscle) e.g. digoxin
