Heart Failure Flashcards
give the three most common causes of heart failure
- IHD
- valvular heart disease
- dilated cardiomyopathy
give the definition of heart failure
when cardiac output is insufficient to meet the metabolic demands of the body
what side of the heart is usually affected first
left
discuss how right sided heart failure occurs
an increase in resistance of the pulmonary vascultature causes the right side of the heart to pump against resistance. The right side of the heart compensates with ventricular hypertrophy, which leads to progressive dilatation and eventular failure
give some rarer causes of right sided heart failure
pulmonary HTN
pulmonary embolism
give the three cardinal signs of left sided heart failure
- pulmonary oedema
- cardiomegaly (displaced apex beat)
- peripheral oedema
give four cardinal signs of right sided heart failure
- raised JVP
- hepatomegaly
- ascites
- peripheral oedema
what can trigger decompensation in a previously stable patient
- poor compliance with medication
- infection
- arrhythmias
- fluid overload
how does decompensation normally present
sudden onset pulmonary oedema and/or peripheral oedema
what are the clinical features of heart failure
- dyspnoea
- nocturnal cough
- chest discomfort
- leg swelling
- fatigue
- orthopnoea + PND
give the signs of heart failure you might see on a CXR
Alveolar oedema Kerley B lines Cardiomegaly Diversion to upper lobes Effusion
what might you see on ECG in heart failure
non specific changes but may include
LBBB
AF
LV hypertrophy
pathological Q waves
what is the initial management of acute heart failure
Oxygen
Morphine
Furosemide
GTN
Sit them up
What is the usual initial pharmacological management of heart failure
Spironolactone, bisoprolol, rampiril and furosemide
ACEi
Beta blockers
diuretics
what should you watch out for when using Ace inhibitors and sprinoloactone together
Hyperkalaemia
