heart failure Flashcards
describe congestion
relative excess of blood in vessels of tissue or organ
describe congestive cardiac failure
heart is unable to clear blood through right and left ventricles due to ineffective pump
what is transudate
alterations in the haemodynamic forces which act across the capillary wall
what is exudate
part of inflammatory process due to increased vascular permeability
what is oedema
the accumulation of abnormal amounts of fluid in the extravascular compartment
what is peripheral oedema
increased interstitial fluid in tissues
what is effusion
fluid collections in body cavities
what is pulmonary oedema
left ventricle failure
aetiology of heart failure
- can be caused by LVSD (left ventricular systolic dysfunction) due to IHD (ischemic heart disease)
- or severe aortic stenosis
prevalence of heart failure
0.4-2%
- prevalence and incidence increase with age
- estimated 60000 patients with HF/LVSD in scotland
prognosis of heart failure
- survival rate for heart failure is worse than that for cancer of the breast, uterus, prostate and bladder
- 60% one year survival rate
symptoms of heart failure
- breathlessness
- fatigue
- oedema
- reduced exercise capacity
clinical presentation of heart failure
- oedema
- tachycardia
- raised JVP
- chest crepitations or effusions
- 3rd heart sounds
- displaced or abnormal apex beat
investigations of heart failure
- 12 lead ECG
- Brain natriuretic peptide - low BNP rules out heart failure or LVSD
- cardiac MRI - more accurate than echo
treatment for heart failure
- diuretics
- ACE inhibitors
- betabloskers
- aldosterone receptor blockers
describe the use and function of loop diuretics
treatment for patients with salt and water retention to reduce symptoms of tiredness, fatigue and improve exercise capacity
benefits of loop diuretics
- induce dieuresis by inhibiting the NA-K-CL transporter in loop of Henle
- work at low glomerlular filtration rates
cons of loop diuretics
patients can become resistant and have adverse drug reactions (dehydration, hypotension, gout etc.)
example of loop diuretics
frusemide
describe the use and function of ACE inhibitors
competitively block angiotensin converting enzyme, preventing the conversion of angiotensin 1 to angiotensin 2
benefits of ACE inhibitors
- reduces preload and after load on heart
- can reduce morbiditiy and mortality
cons of ACE inhibitors
can cause adverse drug reactions like cough, angioedema, renal impairment and failure
example of ACE inhibitors
ramapril
adverse drug reactions of frusemide
dehydration, hypotension, hypokalaemia, hypoantraemia, gout, impaired glucose tolerance
drug-drug interactions with frusemide
aminoglycosides
lithium
NSAIDS
antihypertensives
vancomycin
adverse effects of ramapril
cough, angioedema, renal impairment, renal failure, hyperkalaemia
drug-drug interactions of ramapril
NSAIDs
Potassium supplements
potassium sparing diuretics
what is normal sinus rhythm
60-100BPM
ECG - P wave preceding every Q wave
what is 1st degree heart block
a condition of abnormally slow conduction through the AV node
what characterises 1st degree heart block on an ECG
PR interval of greater than 0.20
what is 2nd degree heart block
the electrical signals between your atria and ventricles can intermittently fail to conduct
what characterises 2nd degree heart block on an ECG
missing QRS complex
what is 3rd degree heart block
complete loss of communication between the atria and the ventricles
what is atrial fibrillation
condition that causes an irregular heart rate
what is atrial flutter
abnormal heart rhythm (arrhythmia) which causes the upper chambers of your heart (atria) to beat too quickly
what is supraventricular tachycardia
episodes of an abnormally fast heart rate. The heart will suddenly start racing, then stop racing or slow down abruptly
whta is wolff-parkinson-white syndrome
a relatively common heart condition that causes the heart to beat abnormally fast for periods of time
what is ventricular tachycardia
type of abnormal heart rhythm, or arrhythmia.
what is ventricular tachycardia
type of abnormal heart rhythm, or arrhythmia.
what is ventricular fibrillation
a type of arrhythmia, or irregular heartbeat, that affects your heart’s ventricles
what are atrial eptopics
arise from the heart’s upper chambers, and are also termed premature atrial contractions (PACs)
what are ventricular ectopics
arise from the heart’s lower chambers, also termed premature ventricular contractions (PVCs)
prevalence of afib
2.5% of the English population
clinical presentations of afib
-palpitations
-dyspnea
-fatigue
-lightheadedness
-chest pain
medical treatment for atrial fibrillation
A beta blocker, such as bisoprolol or atenolol, or a calcium channel blocker, such as verapamil or diltiazem
