heart failure Flashcards
Define HF
Progressive clinical syndrome characterised by structural or functional abnormalities of the heart that produces raised intracardiac pressure and/or reduced cardiac output at rest and/or at exercise
3 main categories
- reduced EF
- mildly reduced EF
- preserved EF
symptoms of HF
- persistent cough/wheeze
- SOB
- ankle swelling
- reduced exercise tolerance
- fatigue
3 signs of HF
- pulmonary oedema
- basal crepitations (pulmonary cackles)
- elevated jugular venous pressure
Risk factors for HF
- CAD
- MI
- Hypertension
- AF
- DM
- FHx HF or sudden cardiac death <40
- Male
- Smoker
- Elderly
most common cause of HF
CAD
HF often co-exists with other comorbidities e.g
- CHD
- CKD
- AF
- Hypertension
- Dyslipidaemia
- Obesity
- Diabetes mellitus
- COPD
most common cause of HF in Afro/Afro-Caribbean
more likely to develop HF secondary to hypertension
relationship between comorbids and HF prognosis
worse prognosis of HF if pt has comorbidities
Complications of HF
- CKD
- AF
- depression
- cachexia (weakness and wasting of body)
- sexual dysfunction
- sudden cardiac death
Pregnant women/given birth within 6 months and suspected to have HF
- arrange emergency admission or
- seek immediate specialist advice
what to do if HF is suspected clinically
- admission if pt has severe symptoms
- measure natriuretic peptide level (NT-pro-BNP)
- 12-lead ECG in all people
- consider other tests to evaluate for other factors and exclude other conditions
serum natriuretic peptide levels
- normal: HF unlikely
- > 2k ng/l (235pmol/l) - urgent referral for specialist assessment and transthoracic ECG within 2 weeks
- 400-2k ng/L (47-236) refer for above within 6 weeks
does level of natrueitic peptide indicate type of HF
No - does not differentiate between different types (e.g. if reduced, preserved EF etc)
name 2 markers that are strong RF and prognostic markers of poor outcomes in pt with suspected HF
- anaemia
- high platelet: lymphocyte % (low lymphocyte count)
what to do in pt with HF due to valve disease
refer for specialist assessment and give advice regarding follow up