Heart Failure Flashcards
Whats heart failure
Structural or functional abnormalities of the heart resulting in reduced cardiac output
Not enough blood pumped out the heart
Whats the difference between acute and chronic HF
Chronic- progressed overtime
Acute- sudden symptoms, emergency admission to hospital
Chronic HF can develop into acute HF
Symptoms of HF
Ankle swelling
persistent cough and wheezing
SOB
Chest pain (in angina)
Palpitations (in arrhythmias)
Pulmonary oedema
Whats the most common cause of HF
coronary heart disease
Hypertension
Heart valve disease
Arrhythmias
Hypo/hyperthyroidism
Severe anaemia
How is HF diagnosed
Blood test : NT-proBNP increases in HF
ECG, urine, signs of fluid retention such as crackles in lungs, oedema
Lifestyle Management of heart failure
Lifestyle - restrict salt in diet <6g daily recommended
Patient should weigh themselves daily and report weight gain
- 1.5-2.0kg in 2 days - report to GP
When are loop diuretics used in HF
Liquid in lungs present - pulmonary oedema
Whats the 1st line in HF
Acei/ARB and BB
A patient with angina is diagnosed with HF what do you give 1st line
BB followed by acei/arb
An african carribbean is diagnosed with HF what do you give
Hydralazine and nitrate instead of ACEI/ARB as they dont tolerate them
Whats the 2nd line in HF
MRA
If 2nd line is ineffective in HF add
Refer to specialist
If MRA is added and symptoms persist youd ______
Refer to specialist they can add sacubitril or valsartan instead of ACEi/ARB
Or add digoxin, ivabradine
A patient is diagnosed with HF. They also have AF. What do you give and at what dose
Digoxin 125mcg daily
What class of drugs shouldnt be given in HF, unless its ____
CCB
amlodipine
Can BB be used in HF
Only in stable HF
Drugs used in HF
BANDAIDS
BB - only in stable HF
Acei/Arb
Nitrates and Hydralazine
Diuretics (loop/ MRA/thiazide)
Amiodarone
Ivabridine
Digoxin
Sacubitril/ valsartan
Can empagliozin and dapagliflozin be used in HF
What strength
Yes
10mg OD as ADD ON therapy, not alone
What ARBs are used in HF
Candersartan
Losartan
Valsartan
A patient is diagnosed with HF but also has angina and COPD. What do you give
Start with BB +acei after due to angina
Even though BB should be avoided in COPD, diabetes, ED they should be used in HF as benefits outweigh the risk
A patient is diagnosed with angina and HF. What class of drugs should be avoided
CCB cant be used in HF unless its amlodipine
When are loops used in HF
To relieve breathlessness and oedema in patients with fluid retention
When are thiazides used in HF
What does the eGFR need to be for you to be able to use them
In patients with mild fluid retention and eGFR >30
When can mineral corticoid antagonists not be used in HF
If the patient has hyperkalaemia or renal impairment
What vaccine is offered in HF
Annual influenza vaccine
pneumococcal disease
Can NSAIDs be used in HF
No it worsens it. Stop
When are ACEi started first
If they also have fluid overload or diabetes
When would you prescribe ARBs in HF
In those unable to take ACEi due e.g., dry cough
