CHF Flashcards
What is heart failure?
progressive syndrome characterized by structural and/or functional abnormalities in cardiac contraction, adverse neuro-hormonal adaptations and remodeling and co-morbidities that collectively alter myocardial function, fluid regulation, respiration, and perfusion, and overall hemodynamic stability.
What are the AHA heart failure stage? What is recommended tx for each stage.
Stage A: high risk; HTN, coronary artery dz, DM, FHx cardiomyopathy
–Tx: treat htn and lipids, smoking cessation, exercise, limit alcohol, ACEi
Stage: B: asymptomatic; previous MI, LV systolic dysfunction, asymptomatic valvular dz. (Structural changes)
–Tx: PLUS ACEi, beta blockers
Stage C: symptomatic HF: known structural heart dz, SOB and fatigue, reduced exercise tolerance. (Now they feel effects of structural change.)
–Tx: PLUS ACEi, beta blockers, diuretics, digoxin, aldosterone receptor antagonists, dietary salt restriction
Stage D: Refractory end-stage heart failure; marked sx at rest despite maximal medical therapy (failing therapy)
–Tx: PLUS inotropes, transplant, VAD
**Can only move in one direction
What are the NY Heart associated classifications of heart failure?
Class I: minimal (ordinary physical activity doesnt cause undue sxx; no limitations)
ClassII: Mild (Ordinary activity causes sx, no strenous exercise)
ClassIII: Moderate (less than ordinary activity causes sx; activity limited to ADLS)
Class IV: severe (Sx with any physical activity)
*You can move back and forth between these functional classes)
How can we easily assess cardiovascular status?
Determine whether the patient is wet or dry; assessing fluid status and congestion
Determine whether patient is warm or cold by assessing indicators of perfusion
management of heart failure
Stabalize the patient: give diuretic (torsemide & bumetanide is more bioavailable than lasix)
Stabilize the dz:
-ace inhibitor + beta blocker
Treat residual sx: digoxin
