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Cardiovascular system > Heart failure > Flashcards

Heart failure Flashcards

1
Q

what are 4 symptoms of heart failure

A

breathlessness
fatigue
oedema
reduced exercise capacity

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2
Q

what are signs of heart failure

A 
oedema
tachycardia
raised JVP
chest crepitations
chest effusions
3rd heart sounds
displaced apex beat
abnormal apex beat
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3
Q

what are the 4 main tests used for heart failure

A

ECHO
radionucleotide scan - invasive test
left ventriculogram
cardiac MRI

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4
Q

what are potential screening tests for heart failure

A

12 lead ECG

BNP

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5
Q

what is BNP screening

A

brain natriuretic peptide testing
it is a blood test
it measures levels of a protein called BPN

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6
Q

what is BPN

A

it is a protein made by your heart and blood vessels

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7
Q

what do high levels of BNP indicate

A

high levels are normal when you have heart failure

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8
Q

what will cause heart failure

A

any structural heart disease

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9
Q

state some structural heart diseases that cause heart failure

A 
left ventricular systolic dysfunction
left ventricular diastolic dysfunction
valvular heart disease
pericardial constriction
pericardial effusion
cardiac arrhythmias
myocardial ischaemia
myocardial infarction
restrictive cardiomyopathy
right ventricular failure
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10
Q

what is left ventricular systolic dysfunction

A

it is a condition that often leads to heart failure, it may either be asymptomatic or also have symptoms of heart failure

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11
Q

what is left ventricular systolic dysfunction characterised by

A

dilation of the left ventricle and also by vasoconstriction

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12
Q

what are the 4 main causes of left ventricular systolic dysfunction

A

ischaemic heart disease
severe aortic valve disease
severe mitral valve regurgitation
dilated cardiomyopathy

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13
Q

what is aortic valve disease

A

it is a condition in which the valve between the left ventricle and the aorta doesn’t work properly

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14
Q

what is dilated cardiomyopathy

A

it is a condition in which the heart’s ability to pump blood is decreased because the heart’s left ventricles is enlarged and weakened

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15
Q

in some cases what does dilated cardiomyopathy prevent

A

the heart from relaxing and filling with blood as it should

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16
Q

what are investigations of heart failure

A 
ECG
CXR
ECHO
CT coronary angiogram
cardiac MRI

most patients should be assessed by a cardiologist

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17
Q

what is the modern pharmacological treatment of heart failure, this is heart failure due to left ventricular systolic dysfunction

A 
diuretics (furosemide)
ACE inhibitors (ramipril)
ARBs
beta blockers (carvedilol)
aldosterone receptor blockers (spironolactone)
ARNI's (entresto)
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18
Q

what are symptoms of NYHA class 1 heart failure

A

no exercise tolerance

no symptoms during usual activity

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19
Q

what are symptoms of NYHA class 2 heart failure

A

mild limitation of exercise tolerance

comfortable with rest or with mild exertion

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20
Q

what are symptoms of NYHA class 3 heart failure

A

moderate limitation of exercise tolerance

comfortable only at rest

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21
Q

what are symptoms of NYHA class 4 heart failure

A

severe limitation of exercise tolerance

any physical activity brings discomfort and symptoms occur at rest

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22
Q

what are the main treatments for heart failure

A

healthy lifestyle changes
medication
devices implanted in your chest to control your heart rhythm
surgery

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23
Q

what are lifestyle changes recommended

A 
stopping smoking
eating healthily
moderating alcohol consumption
cutting down salt intake
regular exercise
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24
Q

how are lifestyle changes a form of treatment for heart failure

A

lifestyle changes can help relieve your symptoms and can reduce your risk of becoming seriously ill

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25
Q

what are some of the medications for heart failure

A 
ACE inhibitors
beta blockers
angiotensin receptor blockers
hydrazine with nitrate
diuretics
aldosterone antagonists
sacubitril valsartan
ivabradine
digoxin
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26
Q

how are ACE inhibitors medication for heart failure

A

they work by relaxing and opening up your blood vessels

makes it easier for your heart to pump blood around the bod

27
Q

what are side effects of ACE inhibitors as a medication for heart failure

A

dry cough is a common side effect
cause blood pressure to fall too low sometimes
may cause kidney problems

28
Q

describe beta blockers as medication for heart failure

A

beta blockers work by slowing your heart rate down, they protect your heart from the effects of adrenaline and noradrenaline

beta blockers protect against fight or flight chemicals produced by the body

29
Q

what are possible side effects of beta blockers as medication for heart failure

A

dizziness
tiredness
blurred vision

30
Q

describe angiotensin receptor blockers as medication for heart failure

A

work in a similar way the angiotensin converting enzyme inhibitors, they relax blood vessels and reduce blood pressure

31
Q

when are angiotensin receptor blockers used as medication for heart failure

A

they are used as an alternative for ACE inhibitors, however, they are not as effective

however angiotensin receptor blockers do not cause cough

32
Q

what are possible side effects of angiotensin receptor blockers as medication for heart failure

A

low blood pressure and high levels of potassium in your blood are possible side effects

33
Q

describe hydrazine with nitrate as medication for heart failure

A

hydrazine with nitrate in combination can help relax and open up the blood vessels

34
Q

what are possible side effects of hydrazine with nitrate as medication for heart failure

A

side effects can include headaches, a fast heartbeat and palpitations

35
Q

what are diuretics

A

they are water pills, drugs that make you pass more urine

36
Q

what do diuretics help relieve

A

ankle swelling and breathlessness

37
Q

what are possible side effects of diuretics

A

dehydration and reduced levels of sodium and potassium in the blood

38
Q

what is heart failure caused by

A

many conditions that damage the heart muscle, including coronary heart disease

39
Q

list conditions that can lead to heart failure

A 
coronary heart disease
high blood pressure
cardiomyopathy
arrhythmias
damage or other problems with the heart valves
congenital heart disease
anaemia
excessive alcohol consumption
overactive thyroid
pulmonary hypertension
40
Q

state 3 common symptoms of heart failure

A

breathlessness
fatigue
swollen ankles and legs

41
Q

state less common symptoms of heart failure

A 
persistent cough
wheezing
bloated tummy
loss of appetite
weight gain
weight loss
confusion
dizziness
fainting
fast heart rate
palpitations
42
Q

state 5 tests for heart failure

A 
blood tests
ECG
ECHO
breathing tests
CXR
43
Q

what is chronic heart failure characterised by

A 
progressive cardiac dysfunction
breathlessness
tiredness
neurohormonal disturbances
sudden death
44
Q

define heart failure

A

it is the state in which the heart is unable to pump blood at a rate commensurate with the requirements of the tissues or can do so only from high pressures

45
Q

state 2 types of heart failure

A

systolic heart failure

diastolic heart failure

46
Q

what is systolic heart failure

A

decreased pumping function of the heart, which results in fluid back up in the lungs and heart failure

47
Q

what is diastolic heart failure

A

it involves a thickened and stiff heart muscle - the heart does not fill with blood properly

48
Q

what does diastolic heart failure result in

A

fluid backup in the lungs and heart failure

49
Q

what does systolic heart failure result in

A

fluid back up in the lungs and heart failure

50
Q

what are the major risk factors associated with heart failure and coronary artery disease

A 
a history of previous myocardial infarction
hypertension
valvular heart disease
alcoholism
diabetes
congenital heart defects
51
Q

what are additional heart failure risk factors

A 
obesity
age
reduced/falling vital capacity
smoking
high/low haematocrit level
52
Q

describe frank starling law in relation to systolic dysfunction

A

the strength of the heart’s systolic contraction is directly proportional to its diastolic expansion with the result that under normal physiological conditions the heart pumps out of the right atrium all the blood returned to it without letting any back up in the veins

53
Q

what does the renin angiotensin aldosterone system cause the release of

A

angiotensin 2 and aldosterone

54
Q

what is pulmonary oedema

A

it is a condition caused by excess fluid in the lungs, the fluid collects in the alveoli - making it difficult to breathe

55
Q

what are the 2 goals of heart failure management

A

improve symptoms

improve survival

56
Q

what is the treatment to improve symptoms of heart failure

A

diuretics and digoxin

57
Q

what is the treatment to improve survival of heart failure

A

beta blockers and ivabradine

58
Q

what is the treatment to improve symptoms and survival together of heart failure

A

ACE inhibitors
ARBs
spironolactone
valsartan-sacubitril

59
Q

what is a loop diuretic

A

it is a diuretic which inhibits resorption of water and sodium from the loop of Henle

60
Q

state 2 adverse drug reactions with diuretics

A

Severe dehydration

development of gout

61
Q

state 4 treatments to reduce mortality relating to heart failure

A

angiotensin blockade
beta receptor blockade
aldosterone blockade
atrial and brain natriuretic peptide enhancement

62
Q

state 3 angiotensin converting enzyme inhibitors

A

ramipril
enalapril
lisinopril

63
Q

what are beta blockers

A

any of a class of drugs which prevent the stimulation of the adrenergic receptors responsible for increased cardiac action, used to control heart rhythm, treat angina and reduce high blood pressure

64
Q

what are positive inotropes

A

agents that
increase the strength of muscular contraction,
increase the quantity of intracellular calcium available for binding by muscle proteins,
increase the sensitivity of contractile proteins to calcium

Cardiovascular system (34 decks)

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