Heart Failure Flashcards
What is definition of heart failure?
Is chronic version of acute heart failure
It is caused by either impaired left ventricular contraction ( systolic heart failure) or impaired left ventricular relaxation ( Diastolic heart failure). When blood cant flow through left hand side of the heart and out into the body. It backs up into left atrium - pulmonary veins - lungs
What are presentations of Chronic heart failure?
Breathlessness - Worse on exertion
Cough - flem is frothy white
Orthopnea - Shortness of breath when lying down
Paroxysmal nocturnal dyspnoea
Peripheral Oedema
What is Paroxysmal nocturnal dyspnoea?
When patient suddenly wakes up at night and feels shortness of breath + cough
Symptoms improve after few minutes
Why this happens because fluid spreads in lung when lying down and respiratory centre is less responsive when a sleep.
During Night time adrenaline is lower which makes heart relax which makes heart failure worse at night.
Diagnosing Chronic Heart failure?
Clinical Assessment
BNP blood test is done = released from ventricle
Echocardiogram
ECG
Causes of chronic Heart failure?
Ischaemia heart disease
Valvular heart disease
Hypertension
Arrhythmias
Management of heart failure?
Check BNP if above 2000 urgent
Medical managment
Aortic stenosis
Mitral regurgitation
Heart failure specalist nurse gives advice
Medical management of heart failure?
A: Ace inhibitor
B: Beta blocker
A: Aldosterone antagonist
L: Loop diuretics
What is cor purmonale?
Is right sided heart failure caused by respiratory disease like COPD.
Increase pressure and resistance in the pulmonary arteries called pulmonary hyper tension which causes right ventricle not being able to pump blood as theres pressure causing back flow of blood into systolic venous system.
What causes cor purmonale?
COPD
Pulmonary Embolism
Interstital Lung disease
Cystic fibrosis
Primary pulmonary Hypertension
Presentation and signs of cor purmonale?
Shortness of breath
Peripheral oedema
Breathlessness on exertion
Syncope
Peripheral Oedema
Third heart sound
Chest pain
Hypoxia
Cyanosis
Raised JVP
Murmurs
Hepatomegaly
Managment of Cor purmonale?
Treat symptoms of underlying issue
Long term oxygen
What will chest x-ray show for heart failure
A: Alveolar oedema
B: B - lines
C: Cardiomegaly
D: Dilated upper lobe
E: Pleural effusion
Exam defination of heart failure?
Inability of heart to deliver blood + oxygen to the body at the rate necessary.
