Heart failure Flashcards
what is low BP
systolic less than 90mmHg / diastolic less than 60mmHg
what peripheral artery diseases
partial or complete obstruction of peripheral arteries e.g. legs
not enough blood suply -> pain and dysfunction
tell tale sign - intermittent claudication
what part of the nervous system responds to low BP
sympathetic - fight or flight increases HR and SV constrict arterioles
what part of the nervous system responds to high blood pressure
parasympathetic - rest and digest
reduces heart rate and stroke volume
arterioles dilate
sympathetic nervous system inhibited
valve insufficency
leaky valve - valve does not close tightly -> blood leakes
leak causes heart to worker harder for less blood to flow across the body
valve disease stenosis
narrowing and stiffness of in opening of aortic valves and stiffness and slight open space in closed aortic valve
systolic heart failure
stretched and thin ventricles can’t pump
symptoms of valve disease
SOB
Orthopnoea - SOB when lying down
reduced exercise tolerance
weakness
chest pain
symptoms of right sided heart failure
distended jugular veins
anorexia
GI distress
weight gain
increased venous pressure
oedema
symptoms of left sided heart failure
restlessness
confusion
orthopnea
tachycardia
cyanosis of fingers, feet, lips
pulmonary congestion - cough wheeze
signs of symptoms of IHD
Angina pectoris - chest pain/discomfort - followed by breathlessness, sweating
anginal pain in arms, upper abdomen, back, neck, jaw
descresed exercise tolerance
arrythmias -
right sided heart failure
too weak to pump enough blood to the lungs - via pulmonary veins
build up of blood in the veins - increases pressure push fluid out of veins into tissue - lead to oedema,
path of the electrical impulse across the heart
SA node generates impulse across left and right atria
impulse reaches atroventricular node through internodal pathway
through septum throufh bundle of his
nundle btranches to the heart
interventricular septum to heart apex
purkinje fibres
medication to treat hypotension
fludrocortisone and midodrine
medication to manage ischemic heart disease
beta blocker
calcium channel blockers
sinoatrial current inhibitors
nitrates
potassium channel openers
medication given to manage peripheral artery disease
antiplatelet, anticoagulants, antihypertensive, statins
medication for hypertension
ACE inhibitor
alpha blockers
beta blockers
angiotensin II antagonists
calcium channel
diuretics
all lower blood pressure
left side heart failure
left ventricle does not pump enough blood across the body specficially cannot handle the amount of blood from the left pulomary veins away from the lungs, blood builds up in pulmonary veins
intermittent claudication
leg pain when walking - pain is relieved at rest
IHD
ischaemic heart disease - reduced blood supply to heart caused by narrowing of coronary arteries - reduce blood supply to heart, reduced oxygen and nutrients supplied to heart - causes chest pain
how is valve disease diagnosed
auscultation of lungs for pulmonary oedema - fine crackles
leg oedema
abdomen swelling
MRI
angiogram
how is peripheral artery disease diagnosed
ankle brachial index ratio of systolic blood pressure to the blood pressure on the arm
how is IHD diagnosed
Ischaemic Heart Disease
electrocardiogram
ambulatory ecg
blood tests - measure toponin, creatine kinase, CRP, fibrinogen
cardiac stress testing - records ECB and BP while walking on a treadmill, speed and inline increase over 12 mins
coronary angiogram - examine blood vessels using injectable dye visible in x ray
echocardiogram - ultrasound of heart to look at size and structure of heart
HF with reduced ejection fraction is systolic or diastolic dysfunction
systolic dysfunction