Congestive Heart Failure Flashcards
What is congestive heart failure (CHF)
heart cannot pump sufficient blood to meet the metabolic demands of tissues
CHF Etiology / Underlying diseases
- IHD
- Hypertension
- Miscellaneous - VHD (vascular heart disease), cardiomyopathies ( heart muscle disease), toxins
CHF - S &S
LV - SOB, orthopnea and PND
RV - pedal edema and ascites
CHF - Prognosis
less than 50% five year survival
CHF - Treatment non-pharm
- ID and treat underlying cause
- Lifestyle modification - limit salt intake, exercise, weight loss
- treat exacerbating factors - limit exposure to emotional stress
CHF - Treatment Pharm
- ACE Inhibitors (ARBs)
- Beta blockers
- Spironolactone
- Digoxin
- Diuretics
What is spironolactone?
Pronounced - spy-row-no-lack-tone
Brand names - Aldoactone
Its a synthetic, steroidal antimineralcorticoid agent usually used as a diuretic and antihypertensive but also to reduce elevated/ unwanted androgen activity in body
CHF - Treatment surgery
Implantable cardiovert-defibrillator (ICD)
CHF dental considerations to measure severity of CHF according to NYHA
NYHA - New York Heart Association I - no limitations II - slight limitations of ordinary activity III - significant limitations IV - symptomatic at rest
*AVOID dental surgery at III or IV
CHF - day of dental surgery
- Continue meds perioperatively
- Avoid exacerbating factors - esp. vasopressors and excessive fluids
- Avoid supine position as it may precipitate orthopnea