Heart Failure Flashcards
Module 3
What are 4 classifications of cardiomyopathy?
Dilated CM, hypertrophic CM, restrictive CM, and arrhythmogenic CM
What is the most common cause of HF?
Cardiomyopathy
What are the 2 main types of HF?
HFrEF (EF <40%) and HFpEF (EF >40%)
Which type of HF is common in older women?
HFpEF (EF >40%)
HFrEF is caused by a reduction in
The contractility of the left ventricle (systolic)
Neurohormonal overexpression in HF causes activation of
Adrenergic nervous system and renin-angiotensin system
HFpEF is associated with
Impairment of ventricular filling and relaxation (diastolic)
Activation of the RAAS causes retention of
Sodium and water leading to decreased renal perfusion and increased BUN/Cr
What are 6 causes of HF?
Cardiotoxic medications, autoimmune disorders, familial CMO, infiltrative heart disease (amyloidosis), stress cardiomyopathy (Takotsubo), and substance use
What are symptoms of HF?
Dyspnea, fatigue, lower extremity edema, JVD, paroxysmal nocturnal dyspnea, SOB with exertion or at rest
What is characteristic of amyloidosis?
Protein deposits in organ tissues
According to ACC/AHA guidelines, describe the 4 stages of HF
Stage A: at risk for HF
Stage B: pre-HF
Stage C: symptomatic HF
Stage D: advanced HF
According to NYHA functional classification, describe the 4 stages of HF
Class I: asymptomatic
Class II: mild
Class III: moderate
Class IV: severe
Which disease is an under diagnosed cause of HF?
Amyloidosis
Amyloidosis should be considered in patients with
HFpEF, low-voltage EKG, and hypertrophy on echo (but not on EKG)
What are diagnostic tests that can be done for HF?
Echo, chest x-ray, EKG, cardiac catheterization, cardiac MRI, PET/CT, and exercise tolerance testing
A cardiac MRI would be helpful in ruling out
Amyloidosis or cardiomyopathy
BNP and NT-proBNP promote
Vasodilation, diuresis, and regulation of cardiac remodeling
What should be assessed for in the physical exam when suspecting HF?
JVD, narrow pulse pressure, apical pulse displacement, S3 gallop (indicates fluid overload), cardiac murmur, adventitious lung sounds, and edema
Name 5 differential diagnoses for HF
Mechanical obstruction, COPD, asthma and URI, pleural effusion, pulmonary emboli
BNP levels may be increased with
Age, ACS, atrial fibrillation, anemia, COPD, pulmonary HTN, pneumonia, sepsis, valvular disease, and renal dysfunction
BNP levels may be decreased with
Obesity
What labs should be evaluated when diagnosing HF?
CBC
Serum electrolytes (calcium and magnesium)
Urinalysis
Albumin
Which CBC results can exacerbate HF?
Anemia, IDA, or iron overload
What electrolyte can be affected with fluid overload and diuretics?
Sodium (decreased)
Proteinuria can be evidence of
Renal disease
What albumin level may cause edema?
Decreased levels
What medications can be used in the treatment of HF?
ACEIs, ARBs, BBs, Hydralazine, nitrates, Aldosterone, diuretics, Digoxin, CCBs, inotropics
