Heart Failure Flashcards
What is heart failure?
Cardiac output inadequate for body’s requriements
What cause left-sided HF?
IHD
Cardiomyopathy
Valvular heart disease
What cause right-sided HF?
Secondary to Left-sided
Cor pulmonale
Congenital heart disease
What is CCF?
Mix of right and left sided HF
In systolic HF the heart doesn’t?
pump
In diastolic HF the heart doesn’t?
relax
Systolic HF causes symptoms of HF and reduced pumping function; diastolic HF only shows signs of?
HF
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
What are signs of systolic heart failure?
Tachycardia
Fine crepitations
Pleural effusion
S3
What are signs/symptoms of right sided heart failure?
Oedema
JVP elevated
Hepatomegaly
Ascites
What is found on CXR for left-sided HF?
Cardiomegaly
Bat’s wings shadows (esp. lower zones)
Interstitial fluid
What is found on CXR for right-sided HF?
CXR - normal
Which blood tests would be used to investigated possible heart failure?
FBC U&Es Lipids ?Thyroid function tests BNP ABG
BNP is produced by?
Ventricle for lower heart chambers in HF (also raised by many other things)
Besides blood tests and CXR, how is HF investigated?
ECG ECHO - ?Stress-ECHO Cardiac MRi Cardiac catheterisation Troponin if ACS suspected
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
