Dyspnea (Johnson) Flashcards
What type of HF is associated with inability of ventricle to relax, increased stiffness, decreased compliance, myocardial fibrosis, amyloidosis, acute ischemia, constrictive pericarditis, restrictive cardiomyopathy, SOB, and pulmonary edema?
HFpEF (diastolic HF)
What can cause BNP to increase?
HF, AMI, PE, renal failure, old age, pulmonary HTN, severe COPD, ARDS, sepsis
What are some non-pharmacologic recommendations for tx of HF?
Proactive immunization against influenza and pneumococcal pneumonia, avoid NSAIDs, reduce slat intake, avoid alcohol, no smoking
What should you do if a patient does not want to transfer to a cath lab?
Give fibrinolytic agent (clot buster)
What is a major risk factor that increases CVD 2-4 fold?
DM
What type of HF is associated with bilateral crackles?
Left HF
Which murmur is associated with a “diastolic rumble”?
AI/AR
Define dyspnea
Subjective experience of uncomfortable breathing
What are some pharmacologic tx for HF?
ACEi/ARBs (contraindicated ni pregnancy, angioedema)
BB (don’t use in unstable, decompensated HF)
Statins
ASA
Nitro
Diuretics
Vasodilators
What value of BNP indicates a low likelihood of HF?
<100 pg/mL
Describe the ACC/AHA stages of HF
Stage A: no sx, no structural heart dz
Stage B: no sx, structural heart dz
Stage C: heart failure sx, structure heart dz
Stage D: needs surgery, refractory heart failure
What is the key diagnostic test for HF?
NONE– it is a clinical dx based on hx and presentation
Define HF
Inability of the heart to meet the metabolic demands of the body
What type of HF is associated with decreased exercise tolerance, fatigue, orthopnea, PND and S3 gallop?
HFrEF (systolic HF)
What is the most common cause of HF?
CAD– IHD
What type of HF is associated with tender RUQ?
Right HF
Which murmur is associated with an “opening snap”?
MS
What is the time frame for getting a patient to the cath lab?
Ideally <90 min
What is the most common sx associated with HF?
Dyspnea
What are examples of low output HF?
Dilated cardiomyopathy
Valvular dysfunction
Pericardial disease
What are examples of high output HF?
Hyperthyroidism Pregnancy Anemia Beriberi Pagets dz
What is the EF in systolic? What about diastolic?
Systolic HF (HFrEF): <40% Diastolic HF (HFpEF): normal
Describe the NYNHA functional classification of HF
Class I: no limitation of PA, asymptomatic
Class II: slight limitation of PA, exertional sx with ordinary activity, no sx at rest
Class III: limitations of PA, no sx at rest
Class IV: unable to carry out physical activities w/o sx, sx at rest
