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Cardiovascular > Heart failure > Flashcards

Heart failure Flashcards

1
Q

What is the definition of heart failure?

A

The inability of the heart to deliver blood and oxygen at a rate meeting the requirements of metabolising tissues of the body

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2
Q

What is the main cause of heart failure?

A

Ischaemic heart disease (IHD)

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3
Q

What are some casues of heart failure?

A
  • (IHD)
  • Cardiomyopathy
  • Valvular heart disease
  • Cor pulmonale
  • Hypertension
  • Alcohol excess
  • Any factor that increases myocardial work
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4
Q

Give 5 factors that increase myocardial work

A
  1. Anaemia
  2. Arrhythmias
  3. Hyperthyroidism
  4. Pregnancy
  5. Obesity
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5
Q

Give 5 risk factors for heart failure

A
  1. > 65yrs old
  2. African descent
  3. Being male
  4. Obesity
  5. Previous MI
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6
Q

Give 5 catagories of classification of heart failure

A
  1. New York Heart Association (NYHA) classification
  2. Systolic
  3. Diastolic
  4. Acute
  5. Chronic
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7
Q

What are the classes of the NYHA classification of heart failure?

A
  • Class I: No limitation (asymptomatic)
  • Class II Slight limitation (mild HF)
  • Class III: Marked limitation (moderate HF)
  • Class IV: Inability to carry out any physical activity without discomfort (severe HF)
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8
Q

What is systolic heart failure?

A

The inability of the ventricle to contract normally resulting in a decrease in cardiac output

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9
Q

Give 3 causes of systolic heart failure

A
  1. IHD
  2. MI
  3. Cardiomyopathy
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10
Q

What is diastolic heart failure?

A

The inability of the ventricles to relax and fill fully so SV and CO are decreased

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11
Q

What can cause diastolic heart failure?

A

Ventricular hypertrophy (from chronic hypertension) so there is less space for blood to fill so CO is decreased

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12
Q

What is meat by acute heart failure?

A

Usually means new onset or decompensation of chronic HF

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13
Q

What might be some characteristics of acute heart failure?

A

Pulmonary and/or peripheral oedema with/without signs of peripheral hypotension

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14
Q

Give 3 non-specific symptoms of heart failure

A
  • Shortness of breath
  • Fatigue
  • Ankle swelling
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15
Q

Give 2 specific but insensitive symptoms of heart failure

A
  • Orthopnoea

* Paroxysmal nocturnal dyspnoea

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16
Q

Give 3 non-specific signs of heart failure

A
  • Peripheral oedema
  • Pulmonary crackles (bilateral basal crackles)
  • Tachycardia
17
Q

Give 3 specific but insensitive signs of heart failure

A
  • Raised jugular venous pressure (JVP)
  • 3rd and 4th heart sounds
  • Displaced apex beat
18
Q

What would you use to diagnose heart failure?

A
  • History and physical examination
  • Chest X ray
  • Blood tests
  • ECG
  • Echocardiogram
  • Myocardial perfusion imaging
19
Q

What might you seen on a chest X-ray of someone with heart failure?

A
  • Alveolar oedema
  • Cardiomegaly
  • Dilated upper lobe vessels of the lungs
  • Pleural effusions
20
Q

What blood tests might you do in suspected heart failure?

A
  • BNP
  • FBCs
  • U+Es
  • Liver biochemistry
21
Q

If ECGs and BNP levels are normal, what might it suggest about heart failure?

A

That heart failure is unlikey

22
Q

What should you do if ECGs and BNP levels are both abnormal?

A

Do an echocardiogram

23
Q

What would you look for on an echocardiogram for suspected heart failure

A
  • Assess cardiac chamber dimension
  • Look for regional wall motion abnormalities, valvular disease and cardiomyopathies
  • Look for signs of MI
24
Q

What are the main treaments for heart failure?

A
  • Lifestyle chnges
  • Drugs
  • Revascularisatioin
  • Surgery to repair
  • Heart transplant in young people
  • Cardiac resynchronisation
25
Q

What drugs might be used to treat heart failure?

A
  • Diuretics
  • Aldosterone antagonists
  • ACE inhibitors
  • Hydralazine + nitrates
  • Beta blockers
  • ARBs
26
Q

What does cardiac resynchronisation do?

A

Improves the coordination of the atria and ventricles

27
Q

What are some complications of heart failure?

A
  • Renal dysfunction
  • Systemic thromboembolism
  • LBBB and bradycardia
  • Neurological and psychological complications
  • Rhythm disturbances
  • DVT and PEs
  • Hepatic dysfunction
28
Q

Give 4 rhythm disturbances that may be caused by heart failure

A
  • Atrial fibrillation
  • Atrial flutter
  • Ventricular tachycardia
  • Ventricular fibrillation

Cardiovascular (5 decks)

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