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Cardiology for Finals > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

Acute heart failure

A

Rapid deterioration in cardiac function with inability to meet tissue demands, resulting in congestion.

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2
Q

Causes of acute heart failure

A

Cardiac causes

  • Sudden deterioration of CCF
  • AF

Non-cardiac causes

  • COPD
  • Sepsis
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3
Q

Presentation of acute heart failure

A
  • Dyspnoea
  • Tachypnea
  • Normal/high HR
  • Pink frothy sputum
  • Bibasal crepitations
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4
Q

Investigations for acute heart failure

A

Bloods: Hb, U+Es, BNP, lipids, HbA1c
Imaging: CXR, TOE

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5
Q

Management of acute heart failure

A

Acute management

  • ABCDE
  • Sit up
  • High flow oxygen
  • GTN infusion
  • Diamorphine
  • Frusemide
  • Monitor renal output and vital signs

After stabilisation

  • B-blockers, once stable for 48h
  • Closely monitor
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6
Q

Chronic heart failure - definition

A

Inability of cardiac function to meet tissue demands.

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7
Q

Chronic heart failure presentation

A
  • Dyspnoea
  • Orthopnoea
  • Paroxysmal nocturnal dyspnoea
  • Oedema
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8
Q

Right heart failure - causes and presentation

A

Causes

  • Pulmonary HTN (COPD/cor pulmonale)
  • LVH
  • Tricuspid regurgitation

Presentation

  • Peripheral oedema
  • Ascites
  • Hepatomegaly
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9
Q

Left heart failure - causes and presentation

A

Causes

  • HTN
  • Atherosclerosis
  • Diabetes
  • Aortic stenosis

Presentation

  • Pulmonary oedema
  • Bibasal crackles
  • Displaced apex beat
  • Gallop rhythm
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10
Q

Investigations for chronic heart failure

A
  • Bloods: FBC, U+Es, BNP, lipids, HbA1c

- Imaging: CXR, echo (ejection fraction)

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11
Q

Management of chronic heart failure

A

Lifestyle

  • Smoking cessation
  • Weight loss
  • Exercise

Medical (if ejection fraction <40%)

  • ACE inhibitor
  • Beta-blocker
  • Add diuretic if necessary
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12
Q

Interpreting BNP measurements

A

Acute heart failure

  • BNP < 400: rule out heart failure
  • BNP > 400: do TOE to look for cause of heart failure

Chronic heart failure

  • NT-proBNP > 2000: 2-week referral to cardiology
  • NT-proBNP 400-2000: 6-week referral to cardiology
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13
Q

Interpreting ejection fractions

A

50-70%: normal

40-50%: borderline

<40%: low

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14
Q

CXR findings in pulmonary oedema

A
  • Widespread airspace shadowing (batwing)
  • Septal (Kerley) lines
  • May see pulmonary venous diversion to upper lobes
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15
Q

Factors which can alter BNP levels

A

Raise BNP levels

  • Tachycardia
  • LVH
  • Hypoxaemia
  • COPD
  • Age >70
  • GFR < 60
  • Liver failure

Lower BNP levels

  • Obesity
  • ACEi
  • B-blockers
  • ARBS
  • Spironolactone
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Cardiology for Finals (4 decks)

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