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Systems 1a Revision Decks > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

What is the definition of heart failure?

A

When the heart is unable to clear blood from the left and right ventricles

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2
Q

What can cause heart failure?

A

Ineffective pumping due to ischaemia or heart valve disease

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3
Q

What is the pathophysiology of heart failure?

A
  1. Decreased cardiac output
  2. Decreased GFR
  3. Activation of RAAS
  4. Retention of Na+ and water
  5. Fluid overfilled in veins
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4
Q

What happens as a result of congestive heart failure?

A

Back pressure of venous blood

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5
Q

What effects of congestive heart failure can be seen in the lungs?

A

Associated with left sided heart failure

Pulmonary oedema causing crepitations and tachycardia

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6
Q

What effects of congestive heart failurecan be seen in the liver?

A

Associated with right sided heart failure

Increased JVP, hepatomegaly and peripheral oedema

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7
Q

What is Starling’s Hypothesis?

A

The components affect net flux and filtration are hydrostatic and oncotic pressure along with permeability of endothelium

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8
Q

What is the difference between transudate and exudate?

A

Transudate - fluid thats pushed out

Exudate - fluid that leaks out

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9
Q

What process is usually associated with the presence of exudate?

A

Inflammatory process - due to high vascular permeability

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10
Q

What can be said about the composition of exudate?

A

Higher protein/albumin content

Some water and electrolytes

High specific gravity

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11
Q

What can be said about the composition of transudate?

A

Not much protein/albumin content

Lots of water and electrolytes

Low specific gravity

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12
Q

What is the prevalence of heart failure in the UK as a percentage?

A

0.4-2%

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13
Q

What is the prevalence of asymptomatic LVSD in the UK as a percentage?

A

0.4-2%

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14
Q

What is the mean age at which incident usually occurs with regards to heart failure?

A

74 years old

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15
Q

What is the definition of heart failure?

A

A clinical syndrome comprising of dyspnoea, fatigue or fluid retention, either at rest or on exertion, with accompanying neurohormonal activation

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16
Q

How is Heart Failure graded?

A

Using the New York Association classification for HF

Class I - no limitation
Class II - mild limitation
Class III - moderate limitation
Class IV - Severe limitation

17
Q

What are the typical signs of HF?

A

Oedema, tachycardia, raised JVP, chest crepitation/effusions, third heart sound, displaced or abnormal apex beat

18
Q

What are the symptoms of HF?

A

Breathlessness, fatigue, oedema and reduced exercise capacity

19
Q

List the three essential investigations for heart failure

A
  • 12 lead ECG
  • Brain natriuretic peptide
  • LVEF-MUGA
20
Q

What things can be identified and quantified from an ECG pertinent to heart failure?

A
  • LV systolic dysfunction
  • Valve dysfunction
  • LVH
  • Pulmonary hypertension
21
Q

What is the BNP screening test a good predictor of?

A

Mortality and morbidity

22
Q

What is the left ventricular ejection fraction?

A

Continuous biological variable showing the ratio of ejected blood to total volume

23
Q

How can LVEF be measured?

A

Biplane modified Simpsons rule

MUGA-LVEF

24
Q

What are loop diuretics?

A

Diuretics which work on the ascending limb of the loop of Henlé in the kidneys

25
Q

What are two examples of loop diuretics?

A

Furosemide and bumetamide

26
Q

What is the goal of diuretic therapy for heart failure?

A

Improves symptoms

Does not improve morbidity/mortality

27
Q

What pharmacological agents combat the neurohormonal activation associated with heart failure?

A

ACE-inhibitors target the RAAS

28
Q

What ADRs are associated with treatment for heart failure?

A 
Dehydration 
Hypotension
Hypokalaemia 
Hyponatraemia 
Gout 
Impaired glucose tolerance
29
Q

What drug-drug interactions are common with furosemide?

A

Aminoglycosides - aural and renal toxicity

Lithium - renal toxicity

NSAIDs - renal toxicity

Antihypertensives - profound hypotension

Vancomycin - renal toxicity

30
Q

What are the different roles of the AT1 and AT2 receptors to angiotensin II?

A 
AT1 - 
vasoconstriction 
Vascular proliferation
Aldosterone secretion
Cardiac myocytes proliferation
Increased sympathetic tone

AT2

Vasodilation
Antiproliferation
Apoptosis

31
Q

What is the benefit of using beta-blockade in the treatment of heart failure?

A

Reduce sympathetic tone

Systems 1a Revision Decks (22 decks)

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