Chronic Heart Failure Flashcards
what is chronic heart failure?
Condition in which the heart doesn’t pump enough blood to meet all needs of the body
potential causes of CHF
Ischaemic heart diseases & MI
Cardiomyopathy (dilated or hypertrophy)
Systemic hypertension
Diabetes & obesity
Arrhythmias
Congenital heart defects
- Enlarged heart
- Damage to heart valves
- Murmur
- Myocarditis
- Pulmonary hypertension / COPD
- Drugs and toxins
high output HF
[increased cardiac output]
due to:
- peripheral vasodilation (anaemia, sepsis)
- systemic arterio-venous shunting/fistulae
- Insufficient B1
low output HF
due to reduced cardiac output
symptoms of low output HF
[RHS]
- fluid build up in abdomen
- swelling in legs & feet
[LHS]
- fluid build up in lungs (shortness of breath + cough)
- low tissue perfusion (fatigue)
systolic HF
failure of to contract properly
diastolic HF
failure of heart to relax and fill properly during diastole (e.g. in hypertrophy)
class I HF
[mild]
No limitation of physical activity
Ordinary physical activity doesn’t cause undue fatigue, palpitation or dyspnoea
class II HF
[mild]
Comfortable at rest
fatigue during normal physical activity
class III HF
[moderate]
less than ordinary activity = fatigue
class IV HF
[severe]
Unable to carry out any physical activity without discomfort
Symptoms of cardiac insufficiency at rest
signs & symptoms of CHF
Fatigue and exercise intolerance
Abdominal & peripheral oedema
Breathing difficulties
pathogenesis of CHF
Impaired cardiac contractility and reduced CO
Increased sympathetic activity - due to reduced CO & activation of baroreceptors
Activations of RAAS
Fluid and salt retention
which drug type is used to enhance CO?
positive inotropes
which drug type is used to decrease cardiotoxicity of catecholamines?
beta blockers
e.g. Carvediolol, Nebivolol & Bisoprolol
