Heart Failure Flashcards
What are the 3 types of heart failure you can get?
Right sided
Left sided
Mixed (both)
Slide 2
What are the usual causes for left sided heart failure?
Ischaemic heart disaese due to MI
Cardiomyopathy
Valvular disease.
Slide 3
What are the usual causes for right sided heart failure?
Can be secondary to left heart failure.
Cor pulmonale
Congenital.
Slide 3
What are the signs and symptoms of LVF?
Symptoms: Dyspnoea, orthopnoea, PND, pulmonary oedema (pink, forthy sputum)
Signs: Tachycardia, fine crepitations, pleural effusion, addition of 3rd heart sound.
CXR:
Cardiomegaly
Interstitial fluid.
Slide 4+5
What are the symptoms and signs of Right heart failure?
Symptoms: Oedema
Signs: Oedema (ankle,sacral), elevation JVP, hepatomegaly, ascites.
CXR: Normal.
Slide 6
What is the specific treatment for Cor pulmonale?
Rx diuretics and oxygen only. Slide 7
What is the specific therapy for fast AF?
Digoxin or DC shock. Slide 7
What is the standard drugs given to CCF patients?
Diuretics ACE inihibitors B blockers (caution) Spironolactone (severe) Slide 8
For patients with CCF what is the benifit of them being on ACE inhibitors and a diuretic?
Apart from the symptomatic releif, diuretics cause loss of K, where as ACE inhibitors retain K, so balances out. Slide 9
What are the side effects of ACE Inhibitors?
Angioneurotic oedema
Hypotension
Renal impairment
Cough. Slide 10
What do ARB drugs end in?
‘-artan’ suhc as losartan. Slide 11
What is the effect of B blockers short term on CCF patients and what are the side effects?
Can worsen CCF short term and causes worsening dyspnoea short term. Slide 12
What is spironolactone and what are the side effects?
Alsoterone receptor antagonist. Hyperkalaemia (as they retain K) Renal Dysfunction Gynaecomastia (enlarged breast tissue for men) Slide 13
What is Sacubitril-Valsartan?
Combination of an ARB and neprilysin inhibitor.
Sacubitril blocks Natriuretic peptide breakdown. Slide 15
What do you have to be careful about using Sacubitril-Valsartan?
They also cause angioneurotic oedema, so cannot administer along with an ACE inhibitor. Slide 15
What are therapies for CCF?
Implantable cardiac defibrillator
Cardiac resynchronisation therapy.
What patients can recieve Cardiac resynchronisation therapy?
Patients with bundle branch block. Slide 16
What is the danger of digoxin?
It is excreted very slowly.
1/3 is excreted each day and has a very anrrow therapeutic window. Slide 17
If there is high doses of digoxin, what can its effect be on the ventricle?
Can irritate it and cause ventricular arrhythmias. Slide 18
What is the possible therapy for acute LVF?
Sit them up O2 (mind if they have COPD) IV furosemide \+/- IV diamorphine (mind COPD patients) \+/- IV nitrates Slide 19
