Chronic heart failure Flashcards
Define heart failure
A clinical syndrome comprising of dyspnoea, fatigue or fluid retention due to cardiac dysfunction, either at rest or on exertion, with accompanying neurohormonal activation
What can cause HF?
Left ventricular systolic dysfunction (LSVD)
Severe aortic stenosis
What factors increase the risk of HF?
Age Obesity Diabetes CHD Treatment of AMI Hyperlipidaemia
What factors decrease the risk of HF?
Treatment of:
- CHD
- Hypertension
- CHD
- HLP
- DM
- Obesity
- CHF
Why are most people with HF admitted to hospital?
Breathlessness
What are the symptoms of HF?
Breathlessness
Fatigue
Oedema
Reduced exercise capacity
What are the clinical signs of HF?
Oedema Tachycardia Raused JVP Chest crepitations or effusions 3rd heart sound Displaced or abnormal apex beat Cardiomegaly
What are the European society of Cardiology’s guidelines for diagnosing HF?
1) Symptoms and signs (rest or exercise)
2) Evidence of cardiac dysfunction
3) Response to diuretics (in doubtful cases)
How can you obtain evidence of cardiac dysfunction?
Echocardiography
Radionuclide ventriculography
MRI
Left ventriculography
What are some potential screening tests for HF?
12 lead ECG
Brain natriuretic peptide
Why is Brain natriuretic peptide a sign of HF?
It is secreted by the ventricles of the heart in response to excessive stretching of heart muscle cells (cardiomyocytes)
What can cause LVSD?
IHD
Dilated cardiomyopathy
Severe aortic or mitral valve disease
What can cause dilated cardiomyopathy?
Inherited Toxins Viral infections Systemic diseases e.g. Sarcoidosis, SLE Muscular dystrophies Peri-partum cardiomyopathy Hypertension
Why is echocardiography an essential investigation?
Can tell us:
- LVSD
- Valvular dysfunction
- Pericardial effusion/tamponade
- Diastolic dysfunction
- LVH
- Shunts/congenital heart defects
- hypertension
- right heart dysfunction
What is a normal LVEF?
50-80%
