heart failure Flashcards
what is heart failure caused by?
and what is it
aused by other medical conditions that damage the heart. These include
coronary heart disease, high blood pressure, cardiomyopathy, or an irregular heartbeat.
when the heart is cant provide sufficient oxygen to the body and
is has
how is heart failure classified as HF
Heart failure is generally classified by left ventricular ejection fraction.
The diagram indicates how left ventricular ejection
fraction is measured. In normal adults it is about 50-60% When the left ventricular
WHEN ejection fraction **is less than 40% it **is termed heart failure with reduced ejection fraction.
what happens if HF is with no reduced ef?
If the ejection fraction is at least 50% this is called heart failure with preserved ejection
fraction.
The presentation is clinically the same but the management of heart failure with reduced ejection fraction is different.
There are several measures that patients are recommended to do that are non –pharmacological interventions. These include low salt diet, stopping smoking, take regular exercise, reduce alcohol to a minimum.
Myocardial infarction (MI
due to lack of blood flow, this causes the tissue in the heart muscle to die.
caused by: A blockage of blood flow to the heart muscle (aka heart attack) - treated with asprin/blood thinners
angina
Which pharmacologic agents are used to treat **hypertension in patients with **congestive heart failure?
Diuretics, angiotensin-converting enzyme inhibitors, angiotensin II receptor blocks, blockers (in compensated congested heart failure only) and potassium-sparing diuretics
What is heart failure
occurs when there is inadequate oxygen delivery to peripheral tissues (at rest or during exercise), due to dysfunction of the heart or when adequate oxygen delivery can be maintained only with an elevated left ventricular filling pressure. Heart failure is a condition or a collection of symptoms that weaken or stiffen the heart.
Medicines to help heart failure
Diuretics - symptom mangagement
Angiotensin II
Beta blockers
Digoxin
REQUIRES TDM
Indications:
- Congestive HF
- Atrial fibrillation (irregular) and atrial flutter (regular)
Mechanism of action
- Increased force of myocardial contractions
Side effects:
- Vomiting/nausea
- Arrythmias
- Bradycardia
Aldosterone antagonists (weak diuretics) (-one)
Indication:
- Congestive HFrEF
- Oedema
Mechanism of action:
- Inhibits aldosterone receptor, preventing reabsorption of Na+ in kidneys…more urine output
Example:
- Spironolactone
- Epleronone
Contrainidication:
- Hyperkalaemia
Adverse effects (endocrine):
- ED
- MAN BOOBIES
- Irregular menstruation
Angiotensin receptor neprilysin inhibitor (ARNI)
Indication:
- Congestive HF
Mechanism of action
- Neprilysin inhibitor prevents breakdown of natriuretic peptides, which cause vasodilation and natriuresis
- Valsartan blocks angiotensin II receptor to avoid vasoconstrictor
Combination:
- Valsartan
- Neprilysin inhibitor
Adverse effects:
- Similar to ACEi
Contrainidication:
- ACEi
Angiotensin receptor neprilysin inhibitor (ARNI)
Indication:
- Congestive HF
Mechanism of action
- Neprilysin inhibitor prevents breakdown of natriuretic peptides, which cause vasodilation and natriuresis
- Valsartan blocks angiotensin II receptor to avoid vasoconstrictor
Combination:
- Valsartan
- Neprilysin inhibitor
Adverse effects:
- Similar to ACEi
Contrainidication:
- ACEi
Aldosterone antagonists (weak diuretics) (-one)
Indication:
- Congestive HFrEF
- Oedema
Mechanism of action:
- Inhibits aldosterone receptor, preventing reabsorption of Na+ in kidneys…more urine output
Example:
- Spironolactone
- Epleronone
Contrainidication:
- Hyperkalaemia
Adverse effects (endocrine):
- ED
- MAN BOOBIES
- Irregular menstruation
LOOP DIARETICS
Indication:
- HF
- Fluid build-up
Mechanism of action:
- Prevent reabsorption of Na and Cl in kidney, to excrete oedema
Examples:
- Frusemide
- Bumetanide
Pregnancy:
- Avoid
Breastfeeding:
- Caution
Adverse effects:
- Orthostatic hypotension
- Dizziness
- Electrolyte disturbances
