Heart Failure Flashcards

1
Q

What is left CCF mainly due to?

A

IHD (MIs)
Cardiomyopathy
Valvular disease

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2
Q

What is right CCF mainly due to?

A

secondary to LHF
cor pulmonale
congenital heart disease

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3
Q

Symptoms of LVF?

A

dyspnoea (exertion/rest)
orthopnoea
paroxysmal nocturnal dyspnoea
pulmonary oedema

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4
Q

Signs of LVF?

A
displaced apex
pan systolic murmur
tachycardia
fine crepitations
pleural effusion
S3
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5
Q

What might a CXR of LVF show?

A

cardiomegaly
bats wing shadows esp. lower zones
interstitial fluid

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6
Q

What are signs of pulmonary embolism?

A

sunken dyspnoea

pink, frothy sputum

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7
Q

What murmur is assoc. with LVF?

A

pan systolic = functional mitral regurgitation

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8
Q

What heart sound is assoc. with LVF?

A

S3 = gallop rhythm due to rapid ventricular filling

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9
Q

Symptoms of RHF?

A

oedema

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10
Q

Signs of RHF?

A

ankle/sacral oedema
JVP elevated
hepatomegaly
ascites

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11
Q

What would you see on a CXR of RHF?

A

nothing, it good normal

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12
Q

How do you treat CCF due to previous MI or cardiomyopathy?

A
(standard medical treatment for CCF)
Diuretics
ACE inhibitors
B-blockers
Spironolactone
Digoxin
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13
Q

What are the signs of interstitial fluid on CXR?

A

Kerley B lines

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14
Q

How do you treat CCF due to cor pulmonale?

A

Diuretics and O2 only:

e.g. furosemide (would also need K+ supplements) or spironolactone or ACE-I

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15
Q

What is the ideal therapy for CCF due to valvular disease?

A

surgery

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16
Q

How do you treat CCF due to fast AF?

A

digoxin or DC shock

17
Q

Which diuretics help retain and normalise K+ concentration?

A

ACE inhibitors and spironolactone

18
Q

Which type of diuretic would you use in mild CCF?

A

thiazide like diuretics

19
Q

What are some of the side effects of ACE-Is?

A

angioneurmtic oedema
1st dose hypertension esp. if serum Na+ low
renal impairment
COUGH

20
Q

Which drugs can be used instead of ACE-Is?

A

Angiotensin II receptor blockers

21
Q

Give examples of ARBs

A

Losartan and Valsartan

22
Q

What are the initial risks of using b-blockers in CCF?

A

worsening SOB

hypotension

23
Q

Which receptor does spironolactone act on?

A

aldosterone receptor antagonist

24
Q

What are some side effects of spironolactone?

A

hyperkalaemia
renal dysfunction
gynaecomastia

25
Q

How does Ivabradine work and when would you use it?

A

blocks the pacemaker ‘funny current’
slow HR
only use if HR fast despite b-blocers

26
Q

What are the steps of acute LVF therapy?

A
  1. Sit up patient
  2. O2 if hypoxic
  3. IV furosemide
  4. IV diamorphine
27
Q

What is a biomarker for heart failure?

A

BNP
increased BNP distinguishes heart failure from other types of SOB
rises are greater with left over right sided, and with systolic over diastolic dysfunction

28
Q

What is the role of ANP and BNP?

A

assist stretched atria and ventricles - reduce fluid load - relax SM - decrease preload.