Heart Failure Flashcards by Jonas Repkewitz

What is heart failure?

Cardiac output inadequate for body’s requriements

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What cause left-sided HF?

IHD
Cardiomyopathy
Valvular heart disease

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What cause right-sided HF?

Secondary to Left-sided
Cor pulmonale
Congenital heart disease

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What is CCF?

Mix of right and left sided HF

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In systolic HF the heart doesn’t?

pump

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In diastolic HF the heart doesn’t?

relax

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Systolic HF causes symptoms of HF and reduced pumping function; diastolic HF only shows signs of?

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What are symptoms/signs of left sided heart failure?

Dyspnoea
Decreased exercise tolerance 
Fatigue 
Orthopnoea
PND
Nocturnal cough (+/- pink frothy sputum) 
Wheeze 
Nocturia 
Cold peripheries
Weight loss 
Muscle wasting

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What are signs of systolic heart failure?

Tachycardia
Fine crepitations
Pleural effusion
S3

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What are signs/symptoms of right sided heart failure?

Oedema
JVP elevated
Hepatomegaly
Ascites

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What is found on CXR for left-sided HF?

Cardiomegaly
Bat’s wings shadows (esp. lower zones)
Interstitial fluid

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What is found on CXR for right-sided HF?

CXR - normal

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Which blood tests would be used to investigated possible heart failure?

FBC
U&amp;Es
Lipids
?Thyroid function tests
BNP
ABG

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BNP is produced by?

Ventricle for lower heart chambers in HF (also raised by many other things)

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Besides blood tests and CXR, how is HF investigated?

ECG
ECHO - ?Stress-ECHO
Cardiac MRi
Cardiac catheterisation
Troponin if ACS suspected

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How do you treat cor pulmonale induced HF?

Diuretics and O2

How do you treat valvular disease induced HF?

Ideally surgery

How do you treat HF caused by fast AF?

Digoxin or DC shock

How do you treat HF if patient has a HX of previous MIs/Cardiomyopathies?

Diuretics 
ACEI
Beta-blockers
Spironolactone (severe)
(Digoxin, vasodilators) 
(ICD)

Ivabradine acts to?

Decrease HR

What are alternative management options for HF?

LVAd
Transplant
Palliative care

How do you treat acute heart failure?

Sit up
O2
IV furosemide
IV diamorphine (not in COPD)

What is the mechanism of a loop diuretic?

Inhibit NaCl reabsorption in the thick ascending limb of the loop of Henlé

Lop diuretics act to reduce?

Salt and water overload associated with pulmonary oedema (iv) and chronic heart failure

thiazide diuretics like Bendroflumethiazide are used in?

Hypertension Mild heart failure Severe resistant oedema (with loop age)

The benefit from loop diuretics stem from?

Absorption of extracellular fluid contributing to oedema in the capillaries as a consequence of diuretic-induced reduction of blood volum