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Cardioresp > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

Symptoms of heart failure?

A 
Dyspnoea on exertion
Orthopnoea
Paroxysmal nocturnal dyspnoea
Fluid retention 
Nocturnal cough
Lightheadedness or syncope
Anorexia
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2
Q

Signs of heart failure?

A 
Tachycardia
Hypotension
Pulsus alternans
Displaced apex
Raised JVP
Right ventricular heave
Gallop rhythm
Basal crackles
Tachypnoea
Pleural effusions
Tender hepatomegaly
Cyanosis
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3
Q

Investigation for heart failure?

A 
CXR
ECG
Echo
FBC
Cardiac enzymes
N-terminal pro-BNP - >400 = heart failure
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4
Q

CXR finding for heart failure?

A 
Alveolar oedema - bat wings
kerley B lines - interstitial oedema
Cardiomegaly
Dilated upper lobe vessels
pleural Effusion
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5
Q

What is pluses alternans?

A

Strong and weak alternating pulses

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6
Q

Management of acute exacerbation of heart failure?

A

Oxygen
IV furosemide
IV nitrate

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7
Q

Why do patient decompensate in heart failure?

A

Increased metabolic demand e.g. fever, infection, anaemia, hyperthyroid

Increased circulating volume e.g. excessive salt content, renal failure, overhydration

Increased afterload e.g. pulmonary embolism or uncontrolled hypertension

Impaired contractility e.g. medication effects, bradyarrhythmia

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8
Q

Management of stable heart failure?

A 
ACE inhibitor
Beta blockers
Candesartan - ARB
Diuretic or Digoxin
Spironolactone
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9
Q

NYHA class I?

A

No limitation of physical activity

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10
Q

NYHA class II?

A

Slight limitation of physical activity

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11
Q

NYHA class III?

A

Marked limitation of physical activity

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12
Q

NYHA class IV?

A

Inability to carry out physical activity

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13
Q

Major criteria in Framingham, criteria?

A 
PND
Acute pulmonary oedema
Increased heart size
Neck vein dilation
S3 gallop
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14
Q

Minor criteria in Framingham, criteria?

A

Pleural effusion
Ankle oedema
Increased heart rate
Nocturnal cough

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15
Q

Causes of heart failure?

A 
Coronary artery disease
Hypertension
AF
Valve disease
Cardiomyopathies
Infective endocarditis
Anaemia
Endocrine disorders
Cor pulmonale
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16
Q

Management of decompensated heart failure? (haemodynamically stable)

A 
Oxygen
Loop diuretic
GTN
Fluid+salt restriction
Ventilation
17
Q

If loop diuretic is not enough in decompensated heart failure?

A

Spironolactone

or eplerenone

18
Q

Management of decompensated heart failure? (haemodynamically unstable)

A

Oxygen
Inotrope - dobutamine
Ventilation
Intra-aortic balloon pump

Cardioresp (8 decks)

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