heart failure Flashcards
what is a syndrome
a collection of manifestations
what type of shock is CHF an example of
cardiogenic
causes of CHF
- MI
- valvular disease
- cardiomyopathy
- uncontrolled HTN
- CAD
risk factors for CHF
- smoking
- dyslipidemia
- HTN
- ischemic heart disease
- type 2 diabetes + metabolic syndrome
normally CO can increase by how much?
5 times
manifestations of left-sided HF
- activity intolerance
- cyanosis
- hypoxia
- orthopnea
- cough (with frothy sputum)
- paroxysmal nocturnal dyspnea
manifestations of right-sided HF
- dependent edema
- ascites (GI distress)
- anorexia, weight loss
- impaired liver function
what is compensated heart failure
compensatory mechanisms are triggered which mask manifestations
list the 6 compensatory mechanisms of HF
- frank starling law
- SNS
- RAAS
- natriuretic peptides
- endothelins
- cardiac hypertrophy + remodelling
the SNS aims to increase CO by
- tachycardia
- vasoconstriction
- increased contractility
name 2 natriuretic peptides and where they are secreted from
- atrial natriuretic peptide: heart muscle
- brain natriuretic peptide: ventricles d/t excessive stretching of heart muscle cells
what do natriuretic peptides cause
potent diuresis and natriuresis
what do endothelins cause
vasoconstriction
manifestations of CHF
- symptoms of impaired pumping (hypoperfusion, hypoxia, acidosis)
- in compensatory phase will be asymptomatic but have symptoms of compensation (high HR/BP, low blood volume, increased contractility, vasoconstriction)
diagnosis of CHF
- history (risk factors)
- labs (anemia, electrolytes, liver fx, renal fx)
- ECG, echo
treatment of CHF, EF < 40%
ACEI + beta blocker
treatment of CHF, EF > 40%
- treat the cause
- ACEI + beta blocker
- symptoms with activity: angiotensin II receptor blocker
- symptoms at rest: increase doses, add diuretic
general treatments of CHF
- acute: stabilize pt, correct the cause
- chronic: increase fx, remove risks, manage symptoms
- surgery if needed
what is pericarditis
inflammation of the pericardium d/t injury/infection
when there is fibrinous exudate in the pericardial space it is called
restrictive pericarditis
manifestations of pericarditis
TRIAD
- chest pain
- pericardial rub
- serial ECG changes
treatment of pericarditis
- treating the cause
- anti-inflammatories
- antibiotics/antivirals (if infection)
diagnosis of pericarditis
- triad
- x-ray
- ECG
- echo
what is cardiac tamponade
external cardiac compression from fluid/air/pus accumulation in the pericardial space
cardiac tamponade is an example of what type of shock
obstructive shock
manifestations of cardiac tamponade
BECK’S TRIAD
- hypotension
- distended neck veins
- muffled heart sounds (distant sounds)
treatment of cardiac tamponade
pericardiocentesis
