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Y1 CARDIOLOGY > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

How does heart failure most commonly arise?

A

When cardiac output is low (many causes), body thinks fluid is low and so retains fluid, causing fluid overload, thus the heart has to work harder (and often can’t)

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2
Q

What are the main causes of left sided heart failure?

A

Ischaemic heart disease (MI etc.)
Cardiomyopathies
Valvular disease

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3
Q

How do numerous MIs lead to heart failure?

A

Scar tissue is left resulting in reduced contractility, so cardiac output decreases

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4
Q

What are the main causes of right sided heart failure?

A

Secondary to left heart failure
Cor pulmonale
Congenital defects

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5
Q

How does cor pulmonale cause heart failure?

A

Lung disease causes hypoxia, resulting in pulmonary vasoconstriction, causing increased back pressure, so right heart has to work harder and often fails

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6
Q

What are the main symptoms of left heart failure?

A

Dyspnoea on exertion/Orthopnea/PND,

Pink, frothy sputum (pulmonary oedema)

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7
Q

What are the main signs of left heart failure?`

A 
Tachycardia
Crepitations
Pleural effusion
S3 (gallop rhythm)
Cardiomegaly, bats wings on CXR
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8
Q

What are the main symptoms and signs of right heart failure?

A

Ankle swelling
Raised JVP
Hepatomegaly
Ascites

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9
Q

What are the main drugs used for heart failure?

A 
Loop diuretics
ACEi/ ARBs
B blockers
Spironolactone
Digoxin
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10
Q

What invasive therapy can be used to treat heart failure?

A

Implantable defibrilators
Cardiac resynch therapy
LVAD

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11
Q

What does cardiac resynch therapy achieve?

A

If both sides of heart contracting at different times (slight delay), CRT minimises this gap to improve cardiac efficiency

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12
Q

What is the unwanted effect of furosemide?

A

Hypokalaemia

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13
Q

How might hypokalaemia be corrected in heart failure treatment?

A

Use furosemide in conj with ACEi/spironolactone - these cause hyperkalaemia

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14
Q

What type of drug is spironolactone?

A

Aldosterone antagonist

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15
Q

How does left ventricular failure cause pulmonary oedema?

A

LV failure cause LA pressure to rise, causing back pressure on the lungs which increases pulmonary capillary hydrostatic pressure, causing fluid to accumulate in the pleural space

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16
Q

What is the typical history from a patient with heart failure?

A

Alcohol
Smoking
Multiple MIs
Previous cancer

17
Q

What investigations are used in heart failure?

A 
FBC/ U+Es/ Glucose/ Lipids/ LFTs/ TFTs/ Hb
ABG
ECG
CXR
ECHO
Troponin in ACS
18
Q

What are the signs of pulmonary oedema on CXR?

A 
Cardiomegaly
Alveolar bat wings
Kerley B lines
Dilated UL vessels
Enlarged hila
19
Q

What is the therapy used for acute LVF?

A 
ABCDE
Sit up
Oxygen
IV furosemide
IV diamorphine

Y1 CARDIOLOGY (16 decks)

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