Heart failure Flashcards
What is the commonest cause of HF?
Myocardial dysfunction - usually resulting from IHD
What are the less common causes of HF?
Hypertension, alcohol excess, cardiomyopathy, valvular, endocardial, pericardial
What tests would be used to diagnose HF?
History and physical examination CXR Blood tests ECG Echocardiography Myocardial perfusion imaging
What are the systems involved in the protection of survival in HF?
SNS
RAAS
Inflammation
Neuro-endocrine activation
What are the 3 cardinal symptoms of HF?
SOB
Fatigue
Ankle swelling
What are the symptoms of HF?
Orthopnoea Tachycardia Displaced apex beat Added heart sounds/murmurs Nocturnal dyspnoea Shortness of breath (on exertion)
What are the signs of HF?
Peripheral oedema Pulmonary crackles Tachycardia Raised JVP Hepatomegaly Rales and pleural effusion
What classification is used in HF?
New York Heart Association
What are the features of each class of HF?
Class I - no limitation/asymptomatic
Class II - slight limitation (mild HF)
Class III - marked limitation (moderate HF)
Class IV - inability to carry out any physical activity without discomfort (severe HF)
What are the causes of acute decompensation of chronic HF?
Acute mesenteric ischaemia Uncorrected high BP Obesity Superimposed infection AF and arrhythmias Excess alcohol NSAIDS Treatment and Na+ non-compliance Lack of info to patient about diet and medications, etc.
What medications can be used to treat HF?
Diuretics ACE-I Aldosterone antagonism Beta-blockers Angiotensin receptor blockers Hydralazine and nitrates Ivabradine
What surgery may be carried out in HF?
Mitral valve repair Aortic valve replacement Mitral valve replacement Left ventricular re-modeling Transplantation Revascularisation for hibernating myocardium
What alternative therapy may be used in HF?
Resynchronisation
Defibrillators
