Heart Failure Flashcards

1
Q

Types of categorization of heart failure

A

HFpEF = HF w/ preserved ejection fraction

  • “diastolic Heart failure”
  • > 50% EF

HFrEF = HF w/ reduced ejection fraction

  • “systolic Heart failure”
  • <40% EF

CHF = chronic heart failure/congestive heart failure
R or L HF

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2
Q

AHA Stages of heart failure

A

Stage A: high risk of HF without structural heart disease or symptoms of HF

Stage B: structural heart disease without signs/symptoms of HF

Stage C: structural heart disease w/ prior or current symptoms of HF

Stage D: refractory HF that always requires specialized interventions (surgery)

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3
Q

NYHA functional classification

A

Class 1: patients w/ heart disease without limitation of physical activity
- NO SYMPTOMS

Class 2: patients w/ heart disease resulting in slight limitation of physical activity with symptoms only appearing w/ strenuous activity (none at rest)

Class 3: patients w/ heart disease resulting in marked limitation of physical activity. Symptoms arise with mild-moderate activity but no symptoms at rest

Class 4: Patients w/ heart disease resulting in inability to carry on any physical activity without severe symptoms. Symptoms are present at rest.

  • symptoms include fatigue and dyspnea and angina*
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4
Q

What stages and classes are homologous?

A

B = 1

C = can be 1-4

D = 4

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5
Q

Cardinal signs/symptoms for right sided heart failure

A

Peripheral edema (especially in the lower extremities)

Pitting edema

Ascites

RUQ w/ hepatomegaly

JVD

S3 heart sounds

Anasarca (generalized edema)

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6
Q

Cardinal signs/symptoms for left-sided heart failure

A

Fluid backup from heart-> lungs

Causes:

  • dyspena
  • rales in lungs
  • pulmonary edema

Pulses alternans is almost 100% diagnostic for left sided heart failure, but it is only present in cardiac effusions

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7
Q

Common heart failure symptoms regardless of sided

A

Dyspena

Orthopnea

Fatigue

Weakness

Anorexia and cachexia (only in chronic)

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8
Q

Clinical tests/evaluations for heart failure

A

1) ECG:
HFrEF = low QRS complex on ecg

HFpEF =. Normal ECG

2) CBC, CMP and troponin

3) BNP levels
- HF has >400 pg/mL (this tells you that the dyspnea is caused by HF)
- if <100 pg/mL, is almost never heart failure

4) Chest radiography
5) Echo

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9
Q

Major criteria for heart failure

A

Any of the following symptoms

  • paroxysmal nocturnal dyspnea
  • orthopnea
  • elevated JVD
  • S3 sound
  • pulmonary edema or cardiomegaly
  • cardiac cachexia (w/ treatment)

2 major = HF

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10
Q

Minor criteria for heart failure

A

Any of the following symptoms

  • Bilateral leg edema
  • Nocturnal cough
  • Dyspnea on ordinary
  • Hepatomegaly
  • Pleural effusion
  • tachycardia
  • cardiac cachexia (w/out treatment)

1 major and 1 minor = HF

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11
Q

What is the fluid restriction management for refractory HF?

A

1.5-2L per day max

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12
Q

Treatment of typical acute decompression w/ HF

A

If hypertensive causes
- use vasodilators

If volume overload causes
- use diuretics

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13
Q

Treatment of pulmonary edema acute decomposition

A

Combo of the following:

  • Opiates
  • Vasodilator
  • Diuretics
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14
Q

Treatment of low output acute decomposition

A

A combo of

  • vasodilators
  • inotropic therapy (only in low BP)
  • Hemodynamic monitoring
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