CHF Flashcards
symptoms of CHF
fluid overload
SOB
Edema
without symptoms of HF and without structural damage is which class
Class A ACC
structural damage with elevated biomarkers without symptoms of HF
class B
NYHA 1
structural and functional heart damage with SOB, fatigue, and reduced exercise tolerance
Stage C or NYHA 1 2 3
how to differentiate NYHA class 1 2 3
class 1 = no limitation in physical activity
class 2 = slight limitation in physical activity walking up the stairs
class 3 = comfortable at rest but minimal exertion causes symptoms
what is a class D or 4 HF
advanced HF with severe symptoms
unable to carry physical activity without symptoms of HF or Symptoms at rest
lab biomarkers for HF
BNP <100
NT BNP <300
SOB
CO is CI is
stroke volume X HR
CO/BSA
Renin angio tensin-aldosterone system controls how
renin - Angiotensinogen to A1
A1-A2 by ACE
A2 causes vasoconstriction and release of aldosterone from adrenal gland and vasopressin from pituitary
aldosterone causes sodium and water retention and increases K excretion
vasopressin causes vasoconstriction and water retention
non pharm for HF
Sodium < 1500
restrict fluid 1.5-2L
BMI <30
exercise
if increase in weight by 2-4 lbs in one day or 3-5lbs in a week call doc
what are some natural product to help with HF
fish oil
Co Q10
haw thorne
avoid ephedrine
what drugs can worsen HF
Fluid retention drugs, BP increasing or negative inotropic
DPP4 by increasing Ca
Immunosupressant
non DHP
antiarhythmatics class 1 agents
thiazolidinediones risk of edema
itraconazole
doxyrubicin, danurubicin
NSAIDS
alogliptin
procainamide
what are the ways body compensates for HF (decrease CO)
SNS- BB
RAAS- ACE/ARBs/Ara, Loop
Vasopressin- LOOP
Natriuretic peptides- sacubitril
Diogxin directly
ACE BB SGLT2 hydralazine - decrease risk of mortality
1st line for HF
ACE/ARB/ARNI
BB
loop-
2nd line for HF
ARA- must meet GFR and SCR
SGLT2- must meet GFR, with or without diabetes
Hydralazine or BIDIL- AA pts
ivabradine (corlanor)
