Heart Failure Flashcards
what is the most common type of heart failure?
left-sided heart failure
what is LFH also called? (2)
heart failure with reduced ejection fraction (HFrEF)
systolic HF
what is heart failure with preserved ejection fraction
(HFpEF) also called?
diastolic HF
measurement, expressed as a %, of how much blood the LV pumps out with each contraction
ejection fraction
what are 3 causes of HFrEF?
CAD
increased afterload
increased preload
what is the pathophysiology of HFrEF?
systolic dysfunction due to increased resistance to flow
what are 3 causes of HFpEF?
hypertensive cardiomyopathy
impaired relaxation
tachyarrhythmia
what is the pathophysiology of HFpEF?
abnormal diastolic function leading to vascular congestion
thick heart walls are a sign of _____
diastolic failure
thin heart walls are a sign of _____ _____
systolic failure
on physical exam, what should we expect to find in a patient with heart failure? (7)
pulmonary crackles/wheeze
tachypnea
hypoxia
tachycardia
S3 gallop
S2 split
jugular venous distension
what are 4 things in our work up for a patient with suspected heart failure?
BNP
ECG
Chest Xray
Echo
what is secreted from the ventricles in response to elevated LV end-diastolic pressure?
BNP
what diagnostic will tell us the severity of the disease?
BNP
what 4 medications are given to patient with HF? (4)
ARNI/ACE/ARB
beta blocker
MRA (mineralocorticoid receptor antagonist)
SGLT2 inhibitor
what is considered the first line therapy for HF?
Entresto (ARNI)
what medication for HF reduces the risk for cardiovascular death and hospitalization in patient with chronic HF?
entresto (ARNI)
which medication for HF will reduce morbidity and mortality?
ACE inhibitor
what 3 beta blockers are approved to treat HF?
bisoprolol
carvedilol
metoprolol
which medication reduced morbidity and mortality and is considered first line for symptomatic patients with systolic HF?
beta blockers
what are 2 MRAs used to reduce morbidity and mortality in patient with HF?
spironolactone
eplerenone
which medication used for HF helps left ventricular remodeling that occurs in patients with diabetes and HF by reducing the load on the heart?
SGLT2 inhibitor (farxiga)
what medications can help with volume overload in HF?
diuretics (furosemide)
what 3 medications should be avoided in patients with HF?
NSAIDS
CCB
anticoagulants
which medication is good for HF in patients with concomitant afib?
digoxin
what can be used in a patient with HF + BBB or other intraventricular conduction delay?
cardiac resynchronization therapy (CRT)
what is recommended to prevent sudden cardiac death, v-tach, and v-fib?
implantable cardioverter-defibrillator (ICD)
what symptom in a patient is a poor prognostic sign?
weight loss
acute impairment in cardiac pump function resulting in inefficient perfusion to bodily tissues; may represent a new diagnosis or worsening of preexisting chronic HF
acute decompensated HF
a patient presents with congestion, S3, jugular venous distention, cool extremities, frothy/pink sputum, wheezing, rales and wheezing in lungs, and cheyne-stokes respiration. what are they likely experiencing?
acute decompensated HF
what 2 diagnostics can be used in a patient for evaluate for ACS?
cardiac troponins
ECG
what 2 diagnostics can be used for a patient suspected of acute decompensated HF?
echo
BNP
what are the 2 goals of therapy for ADHF?
normalize ventricular filling pressures
restore adequate tissue perfusion
what are the 2 main treatments for ADHF?
loop diuretics
vasodilators
