Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

INTERNAL MED 3+ conditions > Heart failure > Flashcards

Heart failure Flashcards

1
Q

Define HF

A
  • Heart muscle gets damaged and becomes weak
  • Cannot pump properly
  • Unable to generate sufficient CO to meet the demands of the body without an increase in diastolic BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define congestive heart failure

A
  • Breathless

- Abnormal sodium and water retention resulting in oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How can HF be defined?

A

Based of left ventricular ejection fraction (LVEF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define HFrEF

A
  • Signs and symptoms

- LVEF <40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define HFmrEF (mid-range)

A
  • Signs and symptoms
  • LVEF 40-49%
  • Elevated natriuretic peptides
  • At least one:
    1) Relevant structural heart disease (LVH, left atrial enlargement)
    2) Diastolic dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define HFpEF (preserved)

A
  • Signs and symptoms
  • LVEF >50%
  • Elevated natriuretic peptides
  • At least one:
    1) Relevant structural heart disease (LVH, left atrial enlargement)
    2) Diastolic dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are natriuretic peptides?

A
  • Peptides that induce natriuresis - excretion of sodium by the kidneys
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Signs and symptoms of HF

A
  • Weak
  • Tired
  • Breathlessness
  • Swollen extremities
  • Exercise intolerance
  • Hypotension
  • Weight gain (sometimes loss)
  • Dizzy
  • Lost appetite
  • Coughing
  • Signs of inadequate perfusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Prevalence HF Western world

A

1-2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Gender prevalence - HF

A

M slightly more prevalent than F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Incidence of HF is …..

A

increasing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

HF is primarily a condition of the ….

A

elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which is more common - HFpEF or HFrEF

A

HFrEF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Risk factors for HF

A
  • HTN
  • Coronary disease inc. MI
  • Diabetes
  • Valve disease
  • Cigarette smoking
  • Obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Aetiology of HF

A

MANY CAUSES

  • Coronary artery disease
  • HTN
  • Valvular disease
  • Myocarditis
  • Infiltrative disease (amyloidosis, sarcoid etc)
  • Congenital disease
  • Pericardial disease
  • Toxin-induced
  • Infection
  • endocrine
  • Systemic collagen vascular diseases
  • Chemotherapy
  • Nutritional deficiencies
  • Pregnancy
  • Familial cardiomyopathy
  • Tachycardia-induced cardiomyopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pathophysiology of HF

A
  • Initial myocardial insult causes over-expression of multiple peptides with a variety of short and long term effects on the CVS
  • Neurohormonal
  • Remodeling after MI, cardiomyopathy, HTN, valvular disease
  • Remodeling leads to mitral regurgitation - volume overload - disease progression and further remodeling
17
Q

Stages of HF

A

A-D

18
Q

Diagnosis of CHF - what criteria

A

Framingham - clinical diagnosis - need 2 major or 1 major/2 minor

19
Q

Major criteria in Framingham

A
  • Neck vein distension
  • Rales (crackles)
  • Acute pulmonary oedema
  • S3 gallop
  • Increased venous pressure
  • Circulation time >25 seconds
  • Hepatojugular reflux
  • Cardiomegaly
  • Paroxysmal nocturnal dyspnoea/orthopnoea
20
Q

Minor criteria in Framingham

A
  • Ankle oedema
  • Night cough
  • Dyspnoea of exertion
  • Hepatomegaly
  • Pleural effusion
  • <1/3 max vital capacity
  • Tachycardia (>120)
21
Q

Major/minor criteria in Framingham

A
  • Weight loss >4.5kg in 5 days in response to treatment
22
Q

Most common symptoms of LEFT-SIDED heart failure

A

Dyspnoea of exertion or at rest

23
Q

DDx HF

A
  • Age
  • COPD
  • Pulmonary fibrosis
  • Pneumonia
  • PE
  • Post-partum cardiomyopathy
  • Cirrhosis
  • Nephrotic syndrome
  • Pericardial disease
  • Venous stasis
  • DVT
24
Q

Diagnosing HF

A
  • Echocardiogram
  • ECG = no specific features, yet can see risk factors
  • Coronary angiogram
  • CXR = look for fluid retention and vascular congestion
25
Q

Initial treatment for an acute exacerbation of HF

A

Diuretics and O2 (symptom relief)

- If in cardiogenic shock = vasopressors and ventilation

26
Q

HFpEF is more common in …..

A

females

27
Q

Another name for HFpEF

A

Diastolic HF

28
Q

Another name for HFrEF

A

Systolic HF

29
Q

Additional findings with HF (systemic)

A
  • Worsening renal function
  • HYPOnatraemia
  • HYPOalbuniaemia
  • Congestive hepatopathyq
30
Q

Acute management of HF

A
  • ACE inhibitor
  • Lifestyle changes
  • Beta blocker
  • Diuretic
  • Aldosterone antagonist
  • Hydralazine
  • Digoxin
  • Vasopressin
31
Q

Ongoing treatment for HF with LVEF <35% (no left-bundle branch block)

A
  • ICD

- Cardiac transplant

32
Q

Ongoing treatment for HF with LVEF <30% (with left bundle branch block)

A
  • CRT with biventricular pacemaker

- Cardiac transplant

33
Q

Complications of HF

A
  • Pleural effusion
  • Anaemia
  • Acute renal failure
  • Chronic renal insufficiency
  • Acute compensation
  • Sudden cardiac death

INTERNAL MED 3+ conditions (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions