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Cardiology > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

What classification is used in heart failure?

A

NYHA

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2
Q

What is class 1 heart failure

A

No limitation

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3
Q

What is stage 2 heart failure?

A

Slight limitation

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4
Q

What is stage 4 heart failure?

A

Inability to carry out any physical activity without discomfort

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5
Q

What happens in preserved ejection fraction heart failure?

A

Diastolic dysfunction
Relaxation inadequate so filling impaired
EF>40%

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6
Q

What EF is seen in reduced ejection fraction heart failure?

A

<40%

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7
Q

What is congestive heart failure caused by?

A

Both LVSD and RVSD

Blood pools in veins causing congestion in tissues

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8
Q

What is high output heart failure?

A 
Increased demand (pregnancy, hyperthyroid, anaemia) 
Resolves as soon as demand decreases
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9
Q

What are key symptoms and signs of heart failure

A 
Frothy pink sputum
Nocturnal cough/wheeze
Orthopnoea (how many pillows at night)
Paroxysmal Nocturnal Dyspnoea-  suddenly waking at night with  severe SOB and cough
Cool peripheries
Cyanosis
Tachy at rest
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10
Q

What investigation should be done in heart failure?

A 
ECG
ECHO
CXR
BNP
Doppler in 2 weeks if prev MI or high BNP
Bloods: FBC UE LFT TFT Trop BNP Lipids
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11
Q

What are CXR signs of heart failure?

A 
Kerly B lines
Batwinging
Cardiomegaly
Upper lobe diversion
Pleural effusions
Fluid in fissures
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12
Q

What is first line treatment of heart failure/

A

ACEi and BB
Bisoprolol (slows pulse and less contractility)
Ramipril/ARB (ONLY IF REDUCED EF)
(Furosemide is severe oedema)

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13
Q

What must you do before starting Ramipriil?

A

Check renal function and monitor Cr for 2 weeks to check it settles (if tolerating)

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14
Q

What is second line for heart failure?

A

Spironolactone (not strong enough alone)

Dogoxin (AF, sedentary patients)

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15
Q

What causes paroxysmal noctural dyspnoea

A
  1. Fluid settles across lungs
  2. Decreased resp drive due to less responsive repiratory centre so get more hypoxic before they wake up
  3. Reduced adrenalie at night so reduced cardiac output at night
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16
Q

What is most common valve issue to cause heart failure

A

Aortic stenosis

17
Q

What is non medical management of HF?

A

Pneumococcal and flu vaccine
Stop smoking
referral to HF nurses
Surgical correctino of aortic stenosis

18
Q

WHat is pulsus alternans and when is it seen?

A

Pulsus alternans
regular alternation of the force of the arterial pulse
severe LVF

Cardiology (15 decks)

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