Congestive Heart Failure Flashcards
Final and most severe manifestation of nearly every form of cardiac disease
CHF
What is congestive heart failure pathophysiology?
Inability of the heart to pump blood forward at a sufficient rate to meet the metabolic demands of the body (forward failure) or the ability to do so only if the cardiac filling pressures are abnormally high (backward failure)
What is the most common type of CHF?
Systolic
What is the main risk factor for CHF?
CAD number one cause for failure
What are the major causes of death from CHF?
arrhythmias and pump failure
What is the most common cause of right sided heart failure?
Left sided heart failure
Causes of left sided heart failure
Myocarditis
Pericarditis
Valvular heart disease
Myocardial remodeling
Causes of right sided heart failure
Left sided heart failure
Pulmonary valve stenosis
RV infarct
COPD
ARDS
Chronic lung infection
PE
Primary pulmonary HTN
List some factors that can aggrevate heart failure
Medications
New heart disease
Myocardial ischemia
Pregnancy
Arrhythmias
Infections
Thromboembolism
Hyper/hypothyroidism
Endocarditis
Obesity
HTN
Noncompliance
Dietary excess
NY Classification 1
No symptoms or only symptoms
at high exertion (running)
normal
NY Classification 2
Symptoms on ordinary exertion
Walking around the block
NY Classification 3
Symptoms on minimal exertion
Walking to the next room
NY Classification 4
Symptoms at rest
Stage A HF
High risk for developing HF
Patient has risk factors
Has normal EF
Stage B HF
High risk for developing HF
Asymptomatic LV dysfunction
Decrease in EF
No edema, pulmonary issues, etc
Structural heart disease
Stage C HF
Reduced EF
Past or current symptoms of
CHF
Never leave this category – can be
in this category with no symptoms
Stage D HF
End stage CHF
Heart is giving out
CXR Findings in Heart Failure
Cardiac silhouette – enlarged/cardiomegaly
pulmonary congestion
Pulmonary edema (Butterfly or bat-wing pattern)
Redistribution of blood flow from bases to apices (cephalization)
Kerley B lines
Abnormal septal lines seen in HF
(wispy lines on outside of lungs)
What is BNP and why is it important?
B-type Natriueretic Peptide
Expressed primarily in the ventricles and is elevated when ventricular filling pressure are high
Only secreted during heart failure in response to intracardiac pressures (the higher the number, the worse the heart failure)
Normal levels rule out acute HF in the emergency setting
Can also be used to monitor progress of HF
What class of medication prevent the negative remodeling of the LV and help prevent development of HF?
ACE/Arbs
Slows progression, prolong survival
First line medication in heart failure
ACE inhibitors
What class of medication in HF is used to improve survival and mortality rates in all stages of HF
Beta Blockers
What class of medication is the most effective means of providing symptomatic relief in moderate to severe HF (Relieve symptoms of HF but NO effect on progression or survival)
Loop Diuretics
