Heart Failure Flashcards

1
Q

What is heart failure?

A

When the CO is too inadequate for the bodies requirements.

All the symptoms and signs resulting from an abnormality of cardiac structure or function

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2
Q

What might cause heart failure (parts of the heart)?

A
Vessels - coronary artery 
Hypertension 
Valvular disease 
Wiring - arrhythmias 
Muscle - cardiomyopathies caused by multiple things
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3
Q

What happens if the heart failure is caused by a problem with the right side of the heart?

A

Then there could be fluid/blood build up in the bodies circulation

Leading to: Peripheral oedema, ascities

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4
Q

What happens if the heart failure is caused by a problem with the left side of the heart?

A

Then is could cause fluid/blood build up into the lungs.

Leading to: Pulmonary oedema, SOB, orthopnoea + PND

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5
Q

What are the consequences of Right heart failure?

A

Congestion of peripheral tissues
Depended oedema and ascites
Liver congestion - signs related to impaired liver function
GI tact congestion - anorexia, GI distress, weight loss

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6
Q

What are the consequences of Left heart failure?

A

Decreased cardiac output - activity intolerance and signs of decreased tissue perfusion
Pulmonary congestion
Impaired gas exchange - cyanosis and signs of hypoxia
Pulmonary oedema - orthopnoea, cough with frothy sputum, PND

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7
Q

What are the symptoms of HF?

A
Shortness of breath
Reduced exercise tolerance
Orthopnoea
Paroxysmal nocturnal dyspnoea
Ankle Swelling
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8
Q

What are the signs of HF?

A
Elevated JVP
Third heart sound 
Murmur 
Periperal oedema 
Lung crackles
Tachycardia
Dullness to percussion 
Hepatomegaly
Ascites
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9
Q

What different types of HF can you get?

A

Systolic, diastolic
Left sided and right sided
Acute and chronic

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10
Q

What is systolic HF?

A

When there is a failure with the pump

The heart cant pump out blood effectively and cant contract normally resulting in reduced CO

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11
Q

What is diastolic HF?

A

When there is a failure with relaxing and filling of the heart
The heart is stiff, and cant fill properly causing increased filling pressures

Commonly caused by hypertension

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12
Q

What is acute HF?

A

When the signs and symptoms come on very quickly
New onset of heart failure characterised by pulmonary and/or peripheral oedema

Sudden, can be life threatening, needs immediate treatment

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13
Q

What is chronic HF?

A

When HF has developed or progressed slowly

Gradual onset, heart develops compensatory mechanisms, can be stable compensated or decompensated

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14
Q

What are some ‘signs’ in right sided heart failure?

A
Ascities 
Fatigue 
Distended jugular veins 
Enlarged liver and spleen 
Increased peripheral venous pressure 
Gi complaints
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15
Q

What are some ‘signs’ in left sided heart failure?

A
SOB
Cough 
PND
orthopnoea 
Tachycardia
Restlessness
Cyanosis
Exertional dyspnea
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16
Q

Describe some investigations for HF?

A
Bloods (BNP - increased heart stress (atrial stretching))
ABG
ECG - to find acute causes  
CXR 
ECHO
17
Q

Describe the CXR of pulmonary oedema?

ABCDE

A
Alveolar oedema (bat wings)
Kerly B lines (interstitial oedema)
Cardiomegaly 
Dilated prominent upper lobe vessels 
Pleural effusion
18
Q

What is the treatment of chronic heart failure?

A
Treat the case 
Make them feel better 
- Fluid balance, diuretics 
Make them live longer 
- ACE
- BB
- Aldosterone antagonist 
- Device (ICD)
19
Q

What does ACEi do?

A
Blocks the RAAS system - which is linked with cardiac remodelling 
Start low go slow 
Can cause renal impairment 
Dry cough 
Hypotension (as its an antihypertensive)

(PRIL)

20
Q

What does ARB do?

A

Block angiotensin 2 in RAAS

ARTAN

21
Q

Describe BB in treatment of HF?

A

Good in the long term
Star low go slow
In acute can cause initial decrease in cardiac contractility

Can cause hypotension and worsening dysponoea

22
Q

Describe spironolactone in HF?

A

Used in mod to severe CCF
Men can develop gynaecomastia - breasts
Aldosterone receptor antagonist

23
Q

Describe ivabradine in the use of HF?

A

If channel blocker

Only use if HR fast despite BB usage

24
Q

What is the new drug used in HF?

A

Sacubitril-Valsartan
- combo of ARB and Neprilysin inhibitor
Do not use alongside ACEI

25
Q

What might be a rough treatment for acute HF?

A
IV fluosemide (diuretics)
Opiates ( relax patient and dilate venous system reducing blood back to heart to give it a rest)
Iv nitrates
STOP FLUIDS
Treat cause