Heart Failure Flashcards
1
Q
define heart failure
A
a state where the heart is unable to pump blood to adequately perfuse the tissues
2
Q
two types of heart failure
A
- impaired ejection fraction and left ventricular contraction
- inability to relax and diastolic dysfunction
3
Q
presentation of heart failure
A
- orthopnoea or paroxysmal nocturnal dyspnoea
- reduced exercise tolerance
- fatigue
- pink frothy sputum (pulmonary oedema)
- right sided = ankle oedema
- left sided = pulmonary oedema (crepitations)
- pulsus alternans
- 3rd and 4th HS
- JVP
4
Q
diagnosis of heart failure
A
- NYHA functional classification
- Framingham criteria
- volume overload on examination e.g. elevated JVP, oedema (CXR) and murmur
- ECG for cause
- echocardiogram (GOLD standard)
- angiogram
- MRI if alternative diagnosis or infiltrative process suspected
- CPEX (transplant workup)
5
Q
long-term management
A
- lifestyle
- ACEI/ARB (first line)
- beta blockers e.g. bisoprolol or carvedilol
- dobutamine (less tachycardia)
- nitrates (vasodilators)
- diuretics
- LVAD or ICD
- transplant if cardiogenic shock
6
Q
another name for diastolic heart failure
A
HFpEF (heart failure with preserved ejection fraction)
usually >50%
7
Q
normal ejection fraction
A
more than 50%-70%
8
Q
classification of ejection fraction in HF
A
borderline= 40-49% HF= <40%
9
Q
what does it mean if EF is >75%?
A
HOCM
10
Q
how is ejection fraction measured?
A
echocardiogram
11
Q
normal BNP
A
<400
12
Q
causes of heart failure
A
valve dysfunction MI arrhythmias myopathies hypertension infection alcohol infiltration metabolic (phaeochromocytoma, thyroid, anorexia) genetics cocaine
13
Q
what is pulsus alternans?
A
high volume then low volume pulse
14
Q
presentation of LV failure
A
dyspnoea poor exercise tolerance fatigue orthopnoea PND pink frothy sputum (pulmonary oedema)
15
Q
presentation of RV failure
A
peripheral oedema
ascites
nausea
