Heart Failure Flashcards
How may someone with chronic heart failure present?
Breathlessness worsened by exertion
Cough
Orthopnea (SOB while lying flat)
Paroxysmal Nocturnal Dyspnoea
What are the causes of chronic heart failure and how would it present?
Ischaemic heart disease
Valvular heart disease (aortic stenosis)
Hypertension
Arrhythmias (atrial fibrillation)
Diagnose using BNP, echo and ECG
What is the first line medical treatment of chronic heart failure?
ABAL
ACE inhibitor
Beta blocker
Aldosterone antagonist (when symptoms not controlled with A or B)
Loop diuretics (improve symptoms)
What medication must be avoided in patients with valvular heart disease?
ACE inhibitors
What vaccines must people who have chronic heart failure get?
Yearly influenza and pneumococcal vaccines
What can acute LVF be triggered by and what is the presentation of acute LVF?
Triggered by: sepsis, MI, arrhythmias
Presentation: rapid onset breathlessness, causes type 1 respiratory failure, SOB, looking/feeling unwell, cough
Signs: Increased RR Tachycardia 3rd heart sound Reduced O2 sats Bilateral basal crackles
What conditions can raise BNP?
Heart failure Tachycardia Sepsis PE Renal impairment COPD
What are the CXR findings of someone who has acute LVF?
Cardiomegaly
Upper lobe venous diversion
Bilateral pleural effusions
Fluid in septal lines (Kerley B Lines)
What happens in Cor Pulmonale?
Right sided heart failure caused by respiratory disease. The increased resistance results in the right ventricle unable to pump enough blood out
Leads to a backup of pressure
What are the causes of Cor Pulmonale?
Left sided heart failure
COPD
PE
Interstitial lung disease
What are the signs of cor pulmonale?
Hypoxia Cyanosis Raised JVP Peripheral oedema Third heart sound Hepatosplenomegaly
