Heart Failure Flashcards
What is the mortality rate of class III and class IV HF pts
III 40%, IV 50%
What are the primary etiologies of Heart failure?
60-75% CAD
18% idiopathic
12% valvular heart disease
10% HTN
What are some basic causes of Heart Failure?
RV infarct, constrictive pericarditis, mitral stenosis, atrial myxoma, Thyrotoxicosis, A-V fistula Beri Beri
What are the Stages of heart failure?
ABCD
Walk through the different stages of “evolution of heart failure”
A-Risk factors no heart disease; no symptoms
B- Heart disease w/o sx
C- Prior or current HF symptoms, reduced exercise capacity
D- Refractory HF symptoms
Identify risk factors in Grade A staging of Heart failure
CAD, HT, DM, obesity, METABOLIC SYNDROME, excess EtOh
Discuss in greater depth Stage B, including structural changes, symptoms, or etiology
Has LVH, or impaired LV function, previous MI, valvular disease, structural heart disease; hemodynamically stable
Mortality rate is 15%
What are the different NYHA functional classification of Clinical Stages
Class I-IV
Discuss class I NYHA functional classifications
No limitations to physical activity
No sx with ordinary exertion
Discuss Class II NYHA Functional Classification. Include the one year mortality
Slight limitation of physical activity
Ordinary activity causes sx
One year mortality is 15-30%
Discuss class III NYHA Functional classification
Marked limitation of physical activity
Less that ordinary activity causes symptoms
Asymptomatic at rest
15-30% 1 yr mortality
Discuss Class IV NYHA functional classification
Inability to carry out physical activity w/o discomfort
Sx at rest
One year mortality 50-60%
What are the different pathogenesis of heart failure (pathobiology)
Impaired systolic (contractile) function Impaired diastolic function Mechanical abnormalities Disorders of Rate/Rhythm Pulmonary heart disease High output states
What are the different forms of heart disease you are able to see on Echo
Hypertensive heart disease Ischemic heart disease Hypertrophic heart disease Infiltrative heart disease Primary valvular heart disease
Discuss Hypertensive heart disease on CXR and echo
LVH, bigger cardiac silhouette on echo
Discuss the findings on echo for ischemic heart disease
No change in wall size, a less compliant wall
How many degrees does the heart rate go up for every 1 degree F
10 bpm
Discuss the findings on echo for hypertrophic heart disease
Circumferential expansion of the heart including the septum