Heart Failure Flashcards

1
Q

Whats heart failure

A

Structural or functional abnormalities of the heart resulting in reduced cardiac output

Not enough blood pumped out the heart

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2
Q

Whats the difference between acute and chronic HF

A

Chronic- progressed overtime

Acute- sudden symptoms, emergency admission to hospital

Chronic HF can develop into acute HF

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3
Q

Symptoms of HF

A

Ankle swelling
persistent cough and wheezing
SOB
Chest pain (in angina)
Palpitations (in arrhythmias)
Pulmonary oedema

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4
Q

Whats the most common cause of HF

A

coronary heart disease

Hypertension
Heart valve disease
Arrhythmias
Hypo/hyperthyroidism
Severe anaemia

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5
Q

How is HF diagnosed

A

Blood test : NT-proBNP increases in HF

ECG, urine, signs of fluid retention such as crackles in lungs, oedema

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6
Q

Lifestyle Management of heart failure

A

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

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7
Q

When are loop diuretics used in HF

A

Liquid in lungs present - pulmonary oedema

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8
Q

Whats the 1st line in HF

A

Acei/ARB and BB

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9
Q

A patient with angina is diagnosed with HF what do you give 1st line

A

BB followed by acei/arb

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10
Q

An african carribbean is diagnosed with HF what do you give

A

Hydralazine and nitrate instead of ACEI/ARB as they dont tolerate them

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11
Q

Whats the 2nd line in HF

A

MRA

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12
Q

If 2nd line is ineffective in HF add

A

Refer to specialist

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13
Q

If MRA is added and symptoms persist youd ______

A

Refer to specialist they can add sacubitril or valsartan instead of ACEi/ARB

Or add digoxin, ivabradine

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14
Q

A patient is diagnosed with HF. They also have AF. What do you give and at what dose

A

Digoxin 125mcg daily

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15
Q

What class of drugs shouldnt be given in HF, unless its ____

A

CCB

amlodipine

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16
Q

Can BB be used in HF

A

Only in stable HF

17
Q

Drugs used in HF

A

BANDAIDS

BB - only in stable HF
Acei/Arb
Nitrates and Hydralazine
Diuretics (loop/ MRA/thiazide)

Amiodarone
Ivabridine
Digoxin
Sacubitril/ valsartan

18
Q

Can empagliozin and dapagliflozin be used in HF

What strength

A

Yes
10mg OD as ADD ON therapy, not alone

19
Q

What ARBs are used in HF

A

Candersartan
Losartan
Valsartan

20
Q

A patient is diagnosed with HF but also has angina and COPD. What do you give

A

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

21
Q

A patient is diagnosed with angina and HF. What class of drugs should be avoided

A

CCB cant be used in HF unless its amlodipine

22
Q

When are loops used in HF

A

To relieve breathlessness and oedema in patients with fluid retention

23
Q

When are thiazides used in HF

What does the eGFR need to be for you to be able to use them

A

In patients with mild fluid retention and eGFR >30

24
Q

When can mineral corticoid antagonists not be used in HF

A

If the patient has hyperkalaemia or renal impairment

25
What vaccine is offered in HF
Annual influenza vaccine pneumococcal disease
26
Can NSAIDs be used in HF
No it worsens it. Stop
27
When are ACEi started first
If they also have fluid overload or diabetes
28
When would you prescribe ARBs in HF
In those unable to take ACEi due e.g., dry cough