Heart Failure Flashcards
Types of HF based on ejection fraction
HFrEF <=40%
HFmrEF 41-49%
HFpEF >=50%
Etiology
CAD
Htn
Regurgitant valvular lesions
Obstructive valvular lesions
Arrhythmias
Cor pulmonale
Cardiomyopathies
Myocarditis
Pericarditis with effusion
Collagen vascular disease
Endocrine conditions
OSA
Fluid overload
Non cardiogenic pulmonary edema
ARDS
Clinical features Acute or chronic symptoms
Fatigue
Dyspnoea
Orthopnea
PND
Pedal edema
Pink frothy sputum
Examination findings
Pedal edema
Elevated jvp
S3
Rales or crepitations
HM congestive
Ascites
S4
Examination findings
Pedal edema
Elevated jvp
S3
Rales or crepitations
HM congestive
Ascites
S4
Investigations
ECG
CXR
NT pro BNP
Trop I/T
Echo
Holter
MRI
Cardiac CT angio
Nuclear imaging
Chronic HF Rx (HFrEF)
General measures
Pharmacotherapy
Cardiac resynchronisation therapy
Mechanical circulatory support devices
Cardiac transplantation
General measures
Dietary salt restriction
Fluid restriction
Calorie supplementation
DM,Htn comorbidities
Pharmacotherapy
4 pillars of treating HF
ARNI/ACEI/ARB
&
Diuretic (mineralocorticoid receptor antagonist)..spironolactone
&
Beta blocker (MBC.. METOPROLOL,BISOPROLOL,CARVEDILOL)
&
SGLT2 INHIBITORS..dapagliflozin
ARNI
Sacubitril +valsartan
Other drugs
Loop diuretics (frusemide)to decrease congestion
Hydralazine,IDN
Ivabradine if high HR
Other drugs
Loop diuretics (frusemide)to decrease congestion
Hydralazine,IDN
Ivabradine if high HR
Non pharmacological treatment
Implantable cardioverter defibrillator
Cardiac resynchronisation therapy
Ventricular assist device
Intra aortic balloon pump
Cardiac transplantation
Treatment duration of chronic HF
Lifelong
Treatment of HFpEF
SGLT2 INHIBITORS
Diuretics
Treat comorbidities
Treatment of HFpEF
SGLT2 INHIBITORS
Diuretics
Treat comorbidities
Rx of acute HF
Propped up position
O2 delivery
Iv morphine
Iv diuretic
Vasodilators
Inotropes
