heart failure Flashcards

1
Q

describe congestion

A

relative excess of blood in vessels of tissue or organ

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2
Q

describe congestive cardiac failure

A

heart is unable to clear blood through right and left ventricles due to ineffective pump

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3
Q

what is transudate

A

alterations in the haemodynamic forces which act across the capillary wall

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4
Q

what is exudate

A

part of inflammatory process due to increased vascular permeability

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5
Q

what is oedema

A

the accumulation of abnormal amounts of fluid in the extravascular compartment

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6
Q

what is peripheral oedema

A

increased interstitial fluid in tissues

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7
Q

what is effusion

A

fluid collections in body cavities

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8
Q

what is pulmonary oedema

A

left ventricle failure

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9
Q

aetiology of heart failure

A
  • can be caused by LVSD (left ventricular systolic dysfunction) due to IHD (ischemic heart disease)
  • or severe aortic stenosis
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10
Q

prevalence of heart failure

A

0.4-2%
- prevalence and incidence increase with age
- estimated 60000 patients with HF/LVSD in scotland

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11
Q

prognosis of heart failure

A
  • survival rate for heart failure is worse than that for cancer of the breast, uterus, prostate and bladder
  • 60% one year survival rate
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12
Q

symptoms of heart failure

A
  • breathlessness
  • fatigue
  • oedema
  • reduced exercise capacity
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13
Q

clinical presentation of heart failure

A
  • oedema
  • tachycardia
  • raised JVP
  • chest crepitations or effusions
  • 3rd heart sounds
  • displaced or abnormal apex beat
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14
Q

investigations of heart failure

A
  • 12 lead ECG
  • Brain natriuretic peptide - low BNP rules out heart failure or LVSD
  • cardiac MRI - more accurate than echo
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15
Q

treatment for heart failure

A
  • diuretics
  • ACE inhibitors
  • betabloskers
  • aldosterone receptor blockers
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16
Q

describe the use and function of loop diuretics

A

treatment for patients with salt and water retention to reduce symptoms of tiredness, fatigue and improve exercise capacity

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17
Q

benefits of loop diuretics

A
  • induce dieuresis by inhibiting the NA-K-CL transporter in loop of Henle
  • work at low glomerlular filtration rates
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18
Q

cons of loop diuretics

A

patients can become resistant and have adverse drug reactions (dehydration, hypotension, gout etc.)

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19
Q

example of loop diuretics

20
Q

describe the use and function of ACE inhibitors

A

competitively block angiotensin converting enzyme, preventing the conversion of angiotensin 1 to angiotensin 2

21
Q

benefits of ACE inhibitors

A
  • reduces preload and after load on heart
  • can reduce morbiditiy and mortality
22
Q

cons of ACE inhibitors

A

can cause adverse drug reactions like cough, angioedema, renal impairment and failure

23
Q

example of ACE inhibitors

24
Q

adverse drug reactions of frusemide

A

dehydration, hypotension, hypokalaemia, hypoantraemia, gout, impaired glucose tolerance

25
drug-drug interactions with frusemide
aminoglycosides lithium NSAIDS antihypertensives vancomycin
26
adverse effects of ramapril
cough, angioedema, renal impairment, renal failure, hyperkalaemia
27
drug-drug interactions of ramapril
NSAIDs Potassium supplements potassium sparing diuretics
28
what is normal sinus rhythm
60-100BPM ECG - P wave preceding every Q wave
29
what is 1st degree heart block
a condition of abnormally slow conduction through the AV node
30
what characterises 1st degree heart block on an ECG
PR interval of greater than 0.20
31
what is 2nd degree heart block
the electrical signals between your atria and ventricles can intermittently fail to conduct
32
what characterises 2nd degree heart block on an ECG
missing QRS complex
33
what is 3rd degree heart block
complete loss of communication between the atria and the ventricles
34
what is atrial fibrillation
condition that causes an irregular heart rate
35
what is atrial flutter
abnormal heart rhythm (arrhythmia) which causes the upper chambers of your heart (atria) to beat too quickly
36
what is supraventricular tachycardia
episodes of an abnormally fast heart rate. The heart will suddenly start racing, then stop racing or slow down abruptly
37
whta is wolff-parkinson-white syndrome
a relatively common heart condition that causes the heart to beat abnormally fast for periods of time
38
what is ventricular tachycardia
type of abnormal heart rhythm, or arrhythmia.
39
what is ventricular tachycardia
type of abnormal heart rhythm, or arrhythmia.
40
what is ventricular fibrillation
a type of arrhythmia, or irregular heartbeat, that affects your heart's ventricles
41
what are atrial eptopics
arise from the heart's upper chambers, and are also termed premature atrial contractions (PACs)
42
what are ventricular ectopics
arise from the heart's lower chambers, also termed premature ventricular contractions (PVCs)
43
prevalence of afib
2.5% of the English population
44
clinical presentations of afib
-palpitations -dyspnea -fatigue -lightheadedness -chest pain
45
medical treatment for atrial fibrillation
A beta blocker, such as bisoprolol or atenolol, or a calcium channel blocker, such as verapamil or diltiazem