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ICM -- Cardiology > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

What is Heart Failure?

A

A complex clinical syndrome resulting from structural or functional cardiac disorders that impair the ability of the heart to fill with or eject blood

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2
Q

Heart Failure symptoms

A 
Fatigue/Poor Stamina
Dyspnea
Paroxysmal Nocturnal Dyspnea/Orthopnea
Abdominal Fullness/Bloating/Nausea
Edema
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3
Q

Physical Diagnostic Signs of CHF?

A 
Resting Tachycardia
Low systolic BP and narrow PP
Elevated JVP/Hepatojugular Reflex
Rales
S3, S4, or Summation gallop.
Hepatomegaly/Ascites/Edema
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4
Q

Special Symptoms of L CHF

A

Paroxysmal Nocturnal Dyspnea

Orthopnea

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5
Q

How is JVD measured

A

Prop them up to 30 degrees and measure how high above the sternal angle you can see the distended External Jugular. It should be not at all.

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6
Q

Symptoms associated with Right CHF

A

Ankle Swelling
Weight Gain
Fatigue
Musce Atrophy

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7
Q

In CHF, what happens after decreases in Cardiac Output.

A

Increases in sympathetic and RAAS activity. This will lead to increased preload, afterload, contractility, and vasoconstriction.

Overall – Increased Left Ventricular End Diastolic Pressure

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8
Q

Left ventricular remodeling is

A

Changes to the structure of the heart to make it thicker or more thin and stretched out

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9
Q

Causes of CHF

A 
Coronary Atherosclerosis
HTN
Diabetes
Vavluar Heart Disease
Alcohol
Viral
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10
Q

Four stages of CHF based on symptom presence.

A

Stage A – At risk
Stage B – Asymptomatic, but structural changes have begun
Stage C – Beginning Symptoms
Stage D – Worsening symptoms, usually with therapy

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11
Q

Four stages of CHF based on functional classification

A

I – No symptoms + No Limitations
II – Mild Symptoms to ordinary physical activity
III – Marked symptoms with ess than usual activity. Comfortable at rest.
IV – Severe limitations and symptoms at rest. Bedbound.

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12
Q

How to diagnose CHF?

A 
CLinical Exam
Ecg
CXR
BNP
Echo
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13
Q

CXR Findings in Heart Failure

A 
Cardiomegaly
Vascular Engorgement
Cephalization/Kerley B Lines
Pleural Effusions
Enlarged main PA
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14
Q

Whats the deal with BNP?

A

When the heart has increased levels of wall tension, BNP is released (also ANP)

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15
Q

A normal BNP is…

A

below 100

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16
Q

What might you find in the echo of a CHF patient?

A

Different chamber size, evaliate LV systolic and diastolic fxn, regional LV function.
Possibly valve, pericardial, RV abnormalities.

17
Q

Normal Ejection Fraction

A

55-65%

18
Q

Ejection fraction of Mild, Moderate, and Severe CHF

A

Mild – 40-50%
Moderate – 30-40
Severe – Below 30

19
Q

General Measures common to chronic CHF treatments?

A

Sodium Restriction
Weighing yourself daily to check for holding too much water
Vaccinations (Influenza and Pneumococcus)

20
Q

Drugs given purely for symptomatic management of CHF

A

Diuretics

Digoxin

21
Q

Drugs given that improve the symptoms and prognosis of CHF

A 
ACE Inhibiters/ARBs
Hydralizine/isosorbide
B-blockers
Spironolactone
Devices (like ICD, resync)
22
Q

If medicinal treatment can’t get an ejection fraction above 30%, what should you do?

A

Put in a Defibrillator

23
Q

Why do Cardiac resynchronization?

A

Improves LV EF
Improves Symptoms
Reduces Fxnal Mitral Regurh.

IMPROVES SURVIVAL

24
Q

Three types of Advanced CHF treatments

A

Chronic Ionotropic Suport
LVAD
Cardiac Transplantation

25
Q

Examples of chronic ionotropic support drugs

A

Dobutamine

Milrinone

26
Q

Two ways to use an LVAD

A

Bridge therapy

Destination therapy

27
Q

If a patient is “Warm and Wet”, how should you treat?

A

Lasix

28
Q

If a patient is “Cold and Wet”, how should you treat?

A

Inotropic Drugs (Dobutamine, Milrinone, Ca Sensitizers)

29
Q

Why give a CHF patient vasodilators?

A

to decrease preload and afterload

30
Q

Treatment for acute CHF?

A

Address the precipitating cause (MI, offending meds, arrythmia, HTN)
Educate the patient

31
Q

Important details for HF with Preserved LV EF

A

Increased LV filling pressure from LV abnormalities in relaxation and compliance
40-50% of CHF

32
Q

Who gets HF with Preserved LV EF

A

Elderly, History of HTN

CAD Common

33
Q

Treatment for Heart Failure with Preserved LV EF

A

Control BP
Relieve myocardial ischemia
Maintain sinus rhythm
Diuretic

ICM -- Cardiology (9 decks)

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