Heart Failure ☺️ Flashcards

1
Q

Describe hypertrophic cardiomyopathy

  • epidemiology
  • pathophysiology
  • signs, symptoms
A

Genetic (AD) => main cause of sudden cardiac death in young due to ventricular arrythmias
Can be due to HTN

Diastolic dysfunction or increased afterload => LV hypertrophy and radius decreases

Signs and symptoms

  • asymptomatic
  • syncope, ventricular arrythmias,
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe dilated cardiomyopathy

  • epidemiology
  • pathophysiology
  • signs, symptoms
A

Most common due to CHD, HTN

Systolic dysfunction or systolic valve problems => LV radius and wall thickness increases

Signs and symptoms

  • systolic murmur
  • HF signs, S3
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is acute heart failure

  • pathophysiology
  • etiology
A

Sudden onset/worsening of HF
-low CO from functional/structural abnormality => reduced CO, perfusion => pulmonary edema

  • ISCHEMIA (most common)
  • ACS
  • HTN crisis
  • acute arrythmias
  • valvular disease
  • infectious myopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Presentation of AHF

A

SOB, fatigue, reduced exercise tolerance

Cyanosis
High HR
High JVP
Displaced apex beat
Bibasal crackles, peripheral edema
S3
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Investigations for AHF

A

Bloods

  • FBC - rule out anemia, infective causes
  • U&E - electrolyte imbalances
  • BNP - 100+ indicates myocardial damage
Scans 
-CXR 
Alveolar edema
B lines - interstitial edema
Cardiomegaly
Diversion of vessels => upper zones
Effusion
-Echocardiogram - any cardiac tamponade?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Management of AHF

  • management of regular HF meds
  • treatment for all
  • if resp failure
  • if hypotensive/cardiogenic shock
A

Continue regular meds for HF (Bb, ACEi)
-stop Bb if bradycardic/heart block

IV loop - furosemide or bumetanide

O2 - aim for 94-98%
VD - GTN if HTN/aortic regurg/mitral valve disease
-CI/SE - hypotension

If in resp failure - CPAP

If hypotensive/cardiogenic shock

  • inotropes - dobutamine
  • vasopressors - NA
  • mechanical circulatory assistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is chronic heart failure

-pathophysiology

A

Neurohormonal - short term protection but long term damage

Vicious cycle of

  • poor contractility => inadequate CO
  • poor renal perfusion => activates RAAS, SNS
  • increased fluid retention, VC => HTN
  • increased stress on heart => cardiac remodelling but cannot be adequately be perfused => scar formation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Presentation of chronic heart failure

A

SOB, orthopnea, paroxysmal noctural dyspnoea
Cough with pink, frothy sputum
Cachexia - but can be hidden by edema weight

Bibasal crackles
RHF, high JVP, ankle edema, hepatomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Investigations for chronic heart failure

  • definitive
  • bloods
  • scans
A

Definitive - BNP
-if 400+ - LV strain

-FBC => anemia due to chronic poor renal perfusion

ECG, CXR, Echo => electrical, effusions, physical abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Management of CHF

A
1st line
-ACEi and Bb
2nd line
-Aldosterone antagonist => monitor K 
3rd line
-Ivabradine/sacubitril-valsartan/digoxin

Annual influenza vaccine
One off pneumococcal vaccine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly