CHF Flashcards
define stroke volume
volume of blood ejected during each systolic contraction
define ejection fraction
percent of left ventricular blood ejected during each systolic contraction. = stroke volume/end-diastoilc volume
systolic dysfunction HFrEF
heart failure with reduced ejection fraction
ejection is affected, ventricle walls thin
types of issues seen with HFrEF
dilated cardiomyopathies
coronary artery dz
valvular dz (esp. tri and bicuspid valves)
arrhythmias
diastolic dysfunction HFpEF
heart failure preserved ejection fraction
hypertrophy of ventricles which doesn’t allow filling
EJ normal or slightly reduced
issues seen with HFpEF
chronic HTN
hypertrophic or restrictive cardiomyopathy
aortic stenosis
first line tx for HF
diuretics (loop diuretics most commonly used bc 25% of fluid is reabsorbed in loop of Henle)
sxs of HR
FACES fatigue activity decrease cough edema SOB
in pts with a history of MI and reduced EF, what should be used to prevent HF
ACE-I or ARB
T/F: routine combined use of an ACE-I and ARB and aldosterone antagonist is potentiall harmful
true
when are inotropes indicated
last result in acute decompensated HF bc they cause a lot of side effects and increase mortality
never used in outpatient setting
T/F: pts with the highest norepi have the best prognosis with beta blockers
false
adrenergic activation is lethal in chronic HF
pts with highest plasma norepi have worst prognosis and those with lowest norepi have best
which HF drug category is not recommended for pts with asthma
beta blockers
also not good for marked bradycardia
what do you have to watch out for when using nitrates in HR
hypotension and HA
can also cause lupus like syndrome
not recommended unless ACE-I is tolerated
MOA of Digoxin
unclear
NOT due to positive inotropic effect
likely benefits from neurohormonal inhibition
