E1 Cardiomyopathy Flashcards
treatment for obstructive cardiomyopathy (asymmetric septal hypertrophy, IHSS)
- beta-blockers
- CCBs
- avoid digoxin
S&S of left-sided congestive cardiomyopathy
- gallop S3
- pulses alternans
- rales
S&S of right-sided congestive cardiomyopathy
- JVD
- enlarged liver
- edema
- GI (anorexia, poor appetite)
(3) physiologic mechanisms to treat congestive heart failure
- decrease preload
- decrease after load
- increase contractility
drugs used to decrease preload associated w/congestive heart failure
- diuretic
- nitrates
drugs used to decrease afterload associated w/congestive heart failure
- hydralazine
- CCBs
- captopril (and other ACE inhibitors)
- other BP lowering drugs
drugs used to increase contractility associated w/congestive heart failure
digitoxins (make you feel better but don’t improve mortality)
drugs of choice for heart failure
- anti-renal drugs (ACE inhibitor or ARBs)
- beta blockers (may be detrimental for class IV)
2nd line therapy for congestive heart failure
beta-blockers
3rd line therapy for congestive heart failure
anti-aldosterone drugs
types of congestive heart failure
- HTN
- ASHD (atherosclerotic heart disease)
- EtOH
- endocrine (thyroid storm)
- valvular heart disease
- chemo drugs
most common cause of congestive heart failure
- HTN (black > white)
- ASHD (white > black)
most frequent cause of hospitalization in elderly
heart failure
etiologies of heart failure
- coronary artery disease
- hypertension
- idiopathic cardiomyopathy
- myocarditis
- valvular heart disease
- familial
- other : toxic, metabolic
during diagnosis / clinical exam of heart failure patient, what is included in their history?
- dyspnea at rest
- dyspnea on exertion
- orthopnea / paroxysmal nocturnal dyspnea
physical presentation of patient w/heart failure
- resting tachycardia
- S3
- displaced apical impulse
- JVD
- pulmonary crackles (rales)
- hepatojugular reflux
- peripheral edema
ejection fraction, heart size and common etiology of systolic dysfunction in heart failure
< 40% (reduced), enlarged, CAD
ejection fraction, heart size and common etiology of diastolic dysfunction in heart failure
> 40% (normal), normal, HTN
major predictors for congestive heart failure
- NYHA
- ejection fraction
- exercise O2
- age and sex
minor predictors for congestive heart failure
- norepinephrine levels > 600 pg/cc
- ventricular arythmies
- Na < 139
