Heart Failure Flashcards
What are the primary causes of heart failure?
IHD
Dilated cardiomyopathy
Hypertension
What is ejection fraction?
The percentage of blood that is pumped out of the heart during each beat.
Calculated using SV/EDV x100.
What occurs in HFrEF?
There is an ejection fraction of less than 40%.
Caused by reduced contractility due to systolic ventricular dysfunction, which lowers LV ejection fraction, resulting in reduced cardiac output.
What are common causes of HFrEF?
IHD
Valvular heart disease
Hypertension
How does HFpLVEF present?
Will have signs and symptoms of HF, however, ejection fraction will remain above 50%.
What causes HFpLVEF?
Increased stiffness of the ventricle and thus, impaired relaxation.
What causes left-sided heart failure?
Increased left ventricular afterload (due to increased mean aortic pressure, or an outflow obstruction).
Increased left ventricular preload (due to left ventricular volume overload).
What causes right-sided heart failure?
Increased right ventricular afterload (due to increased pulmonary artery pressure).
Increased ventricular preload (due to right ventricular overload).
What can cause left ventricular overload?
Aortic insufficiency
What can cause right ventricular overload?
Tricuspid valve regurgitation
What are symptoms of HF?
Exertional dyspnoea
Orthopnoea
Paroxysmal nocturnal dyspnoea
Fatigue
How does HF present on a CXR?
Alveolar oedema (‘bat-wing’)
Kerley B lines
Cardiomegaly
Dilated upper lobe vessels
Effusions (blunted costophrenic angles)
How is HFpEF managed?
Loop diuretics (e.g. furosemide to relieve fluid overload symptoms)
Manage cause/symptoms
How is HFrLVEF managed?
Think ‘ABAL’
ACE inhibitor
Beta-blockers
Aldosterone antagonist (e.g. spironolactone)
Loop diuretics
How is acute HF treated?
Think ‘LMNOP’
Loop diuretic (e.g. furosemide) IV
Morphine IV
Nitrates (can be sublingual or oral)
Oxygen
Positioning (sit patient up)
Important to also treat the cause of decompensation.
