Heart Failure Flashcards

1
Q

d: heart failure

A

the state in which the heart cannot pump efficiently

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2
Q

Name the causes of HF in UK

A
Coronary Heart disease +/- MI
Hypertension
dilated cardiomyopathy
-patients with no obvs causes family history important
valve disease
tachycardic arrythmias
HEFpEF
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3
Q

Name the most common valve diseases in the elderly?

A

aortic stenosis

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4
Q

What is the SAS response?

A
Phone the nearest PCI centre (Dundee)
Relayed ECG  
Activates a PPCI Team
Immediate treatment
GTN s/l
Aspirin 300mg oral
Clopidogrel 600 mg
Heparin 5000 U iv
Oxygen via  mask
Rapid transport to the activated PCI centre
Go straight to the cath lab
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5
Q

How is the patient managed in CCU?

A
Phone the nearest PCI centre (Dundee)
Relayed ECG  
Activates a PPCI Team
Immediate treatment
GTN s/l
Aspirin 300mg oral
Clopidogrel 600 mg
Heparin 5000 U iv
Oxygen via  mask
Rapid transport to the activated PCI centre
Go straight to the cath lab
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6
Q

What are the Classic symptoms of HF?

A
Shortness of breath
Difficulty breathing at night when recumbent
Orthopnoea
Paroxysmal nocturnal dyspnoea
Reduced exercise tolerance
Fatigue
Tiredness
Ankle swelling
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7
Q

What are common Left sided diseases leading to heart failure?

A

IHD : MIs cardiomyopathy

valvular disease

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8
Q

What are right sided heart diseases that are secondary to left heart failure?

A

cor pulmonale

congenital heart disease

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9
Q

if you have HF what will your pulse do and what is this called?

A

Pulsas Alternans (pulse will alternate weak and strong beats)

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10
Q

can you have a combination of left and right heart failure?

A

yes

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11
Q

symptoms of LVF?

A

Dyspnoea on exertion/rest, orthopnoea, Paroxysmal Nocturnal Dyspnoea, Pulmonary oedema

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12
Q

clinical signs of LVF?

A

tachycardia, fine crepitation, pleural effusion, 3rd heart sound

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13
Q

CXR of LVF?

A

cardiomegaly, bat wings, interstitial fluid

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14
Q

common symptom of RVF?

A

oedema

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15
Q

clinical signs of RVF?

A

oedema (ankle/sacral), JVP elevated, hepatomegaly, Ascites

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16
Q

what will the CXR show for RVF?

A

nothing it will be normal

17
Q

HF is aka

A

congestive cardiac failure CCF

18
Q

Causes of CCF?

A

Previous MI, Cardiomyopathies.
Cor pulmonale – diuretics + oxygen,
Valvular disease – surgery,
Fast AF – Digoxin or DC Shock.

19
Q

Name the standard treatment for CCF? HOW DELIVERED?

A

Diuretics (loop to relieve symptoms [increase dose OR add spironolactone])
2. ACEi (1st line with B-Blocker if LVF, replace with ARB if cough)
3. B-Blockers (calso Ivabradine (only if HR too fast despite B-Blockers)
4. Spironolactone (if symptomatic despite optimum therapy)
5. Digoxin
6. Other Vasodilators (nitrates + hydralazine IF intolerant to ACEi + ARBs)
Implantable Cardiac Defibrillators
Cardiac resynchronisation therapy
Transplantation

20
Q

what is the std treatment for acute HF?

A
  • Treat any arrhythmias
  • Diamorphine IV
  • IV furosemide
  • GTN
21
Q

why is the patient given diuretics?

A

to excrete retained fluid

22
Q

if the patient has refractory oedema what do you give them instead of diuretics and why?

A

oedema resistant to diuretics] add thiazide

23
Q

when is the patient given ivabradine?

A

only if HR too fast despite B-Blockers

24
Q

what is a side effect of spironolactone?

A

gynocomastia

25
What is digoxin only good for? ans what isnt it good for?
only good for AF, not for CCF in sinus
26
When is cardiac resynchronisation therapy allowed?
only for prolonged qrs