Heart failure Flashcards
How is heart failure defined?
When cardiac output is inadequate for the body’s requirements
What happens in systolic failure?
Inability of the ventricles to contract normally
Decreased cardiac output
Ejection fraction is less than 40%
Left ventricular failure can produce what symptoms?
Dyspnoea, orthopnoea and PND Fatigue Nocturnal cough Wheeze Weight loss
Right ventricular failure can produce what symptoms?
Peripheral oedema
Nausea
Anorexia
Pulsation in neck and face
What are the main signs of heart failure?
Oedema (peripheral and pulmonary) Tachycardia Raised JVP Chest crepitations/effusions 3rd heart sound Displaced or abnormal apex beat
What are the 4 main screening tests for heart failure?
12 lead ECG
Brain natriuretic peptide (If HF, levels are high in blood)
Echo (can indicate the cause, confirms LV dysfunction absence or presence)
CXR (Could show cardiomegaly)
Which part of neurohormnal activation causes increased sodium reabsorption and vasoconstriction?
RAA system
ADH production
What is the effect of salt and water retention on blood pressure?
Increases BP
What are the 2 main aims of heart failure treatment?
To improve symptoms
To improve survival
What are the aims of symptommatic treatment?
Inhibition of the detrimental neurohormonal adaptations
Enhacement of beneficial neurohormonal adaptations
Enhances cardiac function
How do ACEIs/ARBs work?
Block the effects of angiotensin II
Give an example for a diuretic
Furosemide
What does digoxin do?
Improves the pumping ability of the heart, which improves the cardiac function
What do vasodilators reduce?
Preload
Afterload
What will spironolactone block the effects of?
Aldosterone
