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Year 2 CR > heart failure > Flashcards

heart failure Flashcards

1
Q

which part of heart is affected in HF

A

ventricles

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2
Q

what is HFpEF

A

> 50% ejection fraction

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3
Q

what is HFrEF

A

<50% ejection fraction

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4
Q

diagnosis of HFrEF

A

symptoms/signs eg peripheral oedema dyspnoea on exertion

corroborated by elevated B-type natriuretic peptide

refer for transthoracic echocardiogram

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5
Q

where is b-type natriuretic peptide synthesised

A

ventricles but also brain a little bit

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6
Q

what does b-type natriuretic peptide inhibir

A

aldosterone and adh

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7
Q

major cause of HFrEF

A

coronary artery disease

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8
Q

other causes of HF

A

hypertension
valvular disease
myocarditis

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9
Q

amyloidosis?

A

abnormal proteins deposited in brain liver heart. “stone heart”

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10
Q

amyloidosis symptoms

A

thickened myocardium
Pulm hypertension
stiff LV

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11
Q

HF chemotherapy risk drug

A

adriamycin

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12
Q

when ventricular remodelling

A

start of HF, RAAS and SNS

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13
Q

diagnostic for HFpEF

A

elevated LV filling pressures during diastole- diastolic dysfunction

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14
Q

what is orthopnoea

A

have to sit up to breathe

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15
Q

signs of HF (7)

A

elevated JVP (raised RA pressure)
3/4 heart sound
cardio megaly
hepatojugular reflex
peripheral oedema
pulmonary crackles
unintentional weight gain

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16
Q

side effect of amlodipine

A

ankle oedema

17
Q

what look for in HF ECG

A

evidence of MI
AF
other arrhythmias

18
Q

ecg findings in HF (4)

A

inferior Q waves
massive anterior T waves and ectopics
LBBB

19
Q

acutre congestive HF treatment

A

diurese cautiously with loop diureti

20
Q

why diurese cautiously?

A

if RV failure or aortic stenosis, can lower preload too much and drop systolic bp dangerously low

21
Q

what do you have to monitor with loop diuretic

A

electrolytes
magnesium and potassium

22
Q

problem with HF and hypokalemia

A

increases risk of arrythmia which already has elevated risk

23
Q

HFrEF chronic pharm management

A

beta blocker (SNS) and loop/thiazide like diuretic
ARNI
or ARB
or ACEI

24
Q

what is ARNI

A

ARB plus neprilysin inhibitor

25
Q

what is neprilysin

A

degrades BNP

26
Q

what meds useless in HFpEF

A

B blockers
ARNI
RAAS inhibitors

27
Q

how to treat HFpEF

A

co-morbidities
fluid retention
SGLT2 inhibitors

28
Q

other very good drugs for HFrEF

A

mineralocorticoid antagonist such as spironolactone
SGLT2 inhibitor

29
Q

QUAD therapy for HFrEF

A

BB, MRA, SGLT2i, ARNI

30
Q

what is SGLT2 inhibitor

A

SGLT2 inhibitors, which are also called gliflozins, are a class of drugs that lower your blood sugar levels by preventing your kidneys from reabsorbing sugar that is created by your body and the extra sugar leaves through in your urine.

31
Q

sglt2 inhibitor example

A

**dapagliflozin

gliflozin is the key ending

32
Q
A

Year 2 CR (33 decks)

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