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

A

frusemide

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

A

ramapril

24
Q

adverse drug reactions of frusemide

A

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

25
Q

drug-drug interactions with frusemide

A

aminoglycosides
lithium
NSAIDS
antihypertensives
vancomycin

26
Q

adverse effects of ramapril

A

cough, angioedema, renal impairment, renal failure, hyperkalaemia

27
Q

drug-drug interactions of ramapril

A

NSAIDs
Potassium supplements
potassium sparing diuretics

28
Q

what is normal sinus rhythm

A

60-100BPM
ECG - P wave preceding every Q wave

29
Q

what is 1st degree heart block

A

a condition of abnormally slow conduction through the AV node

30
Q

what characterises 1st degree heart block on an ECG

A

PR interval of greater than 0.20

31
Q

what is 2nd degree heart block

A

the electrical signals between your atria and ventricles can intermittently fail to conduct

32
Q

what characterises 2nd degree heart block on an ECG

A

missing QRS complex

33
Q

what is 3rd degree heart block

A

complete loss of communication between the atria and the ventricles

34
Q

what is atrial fibrillation

A

condition that causes an irregular heart rate

35
Q

what is atrial flutter

A

abnormal heart rhythm (arrhythmia) which causes the upper chambers of your heart (atria) to beat too quickly

36
Q

what is supraventricular tachycardia

A

episodes of an abnormally fast heart rate. The heart will suddenly start racing, then stop racing or slow down abruptly

37
Q

whta is wolff-parkinson-white syndrome

A

a relatively common heart condition that causes the heart to beat abnormally fast for periods of time

38
Q

what is ventricular tachycardia

A

type of abnormal heart rhythm, or arrhythmia.

39
Q

what is ventricular tachycardia

A

type of abnormal heart rhythm, or arrhythmia.

40
Q

what is ventricular fibrillation

A

a type of arrhythmia, or irregular heartbeat, that affects your heart’s ventricles

41
Q

what are atrial eptopics

A

arise from the heart’s upper chambers, and are also termed premature atrial contractions (PACs)

42
Q

what are ventricular ectopics

A

arise from the heart’s lower chambers, also termed premature ventricular contractions (PVCs)

43
Q

prevalence of afib

A

2.5% of the English population

44
Q

clinical presentations of afib

A

-palpitations
-dyspnea
-fatigue
-lightheadedness
-chest pain

45
Q

medical treatment for atrial fibrillation

A

A beta blocker, such as bisoprolol or atenolol, or a calcium channel blocker, such as verapamil or diltiazem