clinical case for cardiac Flashcards
heart failure is a progressive clinical syndrome that can result from any abnormality in cardiac pump function, what 2 functions are important?
- impaired ventricular filling
- impaired ventricular systolic function
- -> result in impaired in cardiac
what is the numerical def of heart failure?
reduced ejection fraction less than 40%
3 main goals of heart failure management?
- treat the underlying risk factors
- slow progression of heart failure
- prolong survival and quality of life
what is stage A?
- at high risk for heart failure but without risk of structural heart dz or symptoms of heart failure
- hypertension, atherosclerotic dz, diabetes
what drugs can be used for stage A?
ACEI, ARB, thiazide
how is stage B diff from stage A?
asymptomatic valvular disease
drug of choices for stage B?
beta blockers, ACEI
what is stage C?
- structural heart dz with prior or current symptoms of heart failure
- known structural heart dz and symptoms of heart failure
what are the drug of choices for stage C?
diuretics, ACEI, beta blockers, aldosterone antagonist, hydralazine/nitrate
what is stage D?
- refractory heart failure requiring specialized intervention plus usual therapy
- marked symptoms at rest despite maximum therapy. Recurrent hospitalization and unsafe discharge
what is ADHF?
acute decompensated heart failure
what are the 4 major drugs for ADHF?
- diuretics (reduce preload)
- inotropes (increase contractility)
- vasodilators (reduce both preload and afterload)
- natriuretic peptide
what are the 3 diuretics used for ADHF to reduce preload?
- furosemide
- bumetanide
- torsemide
what are the 2 inotropes that can be used for ADHF to increase contractility?
- dobutamine
2. milrinone
what are the vasodilators and natriuretic peptide that can be used for ADHF to reduce both preload and afterload?
- nitroglycerin
- nitroprusside
- nesiritide
