Congestive Heart Failure Flashcards

1
Q

Congestive Heart Failure

  • inability of heart to supply enough blood circulation to meet the body’s needs
  • 80% of patients diagnosed are over 65 yrs old
  • untreated/poorly controlled CHF: high risk for complications during dental procedures (MI, stroke)
A

Causes

Coronary heart disease, cardiomyopathy, HTN, IE, Pulmonary hypertension, PE

Pathophysiology

Inability of heart to pump effectively

Decrease cardiac output, systemic conogestion

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2
Q

Left vs Right Sided Heart Failure

LVHF (most common)

  • caused by HTN (increased workload) or cardiomyopathy
  • eventually leads to RVHF

RVHF

  • most commonly caused by LVHF
  • pure RVHF = cor pulmonale = due to emphysema
  • problem with venous return, results in systemic venous congestion, peripheral edema
A

Signs/Symptoms

  • # 1 dyspnea (congestion of pulmonary vessels)
  • Fatigue
  • Peripheral edema
  • Clubbing of the fingers
  • Distended veins (esp neck)
  • Ascites (distended stomach)
  • Large, tender liver (liver congestion)
  • Enlarged heart on chest radiograph
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3
Q

Medical Management

Diuretics (thiazides, loop/furosamide)

ACEI (prils)

Angiotensin receptor blocker (sartans)

Aldosterone inhibitor (spironolactone)

Beta blockers

Vasodilators (hydralazine)

A

Dental Management

Dental tx: No modification if CHF well controlled

Abx prophy: NO

BP: emergency if BP below 100/60

NSAIDS: Avoid! Can cause fluid retention (prostaglandin renal-protective: increase GFR)

EPI: 2 carp

Bleeding: anticipate due to coumadin, plavix

Chair: may be unable to fully recline

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