Heart Failure Flashcards
Four Types of Heart Failure: 1. 2. 3. 4.
Two Types of Heart Failure:
- Systolic - Impaired Contractions - EF < 40%
- Diastolic - Impaired Relaxation - EF >50%
- Left
- Right
Causes of Systolic Heart Failure:
M
I
C
Causes of Systolic Heart Failure:
Myocardial Infarction
Ischaemic Heart Disease
Cardiomyopathy
Causes of Diastolic Heart Failure: CP T RC H
Causes of Diastolic Heart Failure: Constrictive Pericarditis Tamponade Restrictive Cardiomyopathy Hypertension
Right Ventricular Failure symptoms: PO A A N P E FE N
Right Ventricular Failure symptoms: PO: Peripheral Oedema A: Ascites A: Anorexia N: Nausea P: Pulsation (neck & face) E: Epistaxis FE: Facial Engorgement N: Nocturia
Left Ventricular Failure Symptoms: B/O PND E F W W M C
Left Ventricular Failure symptoms: B/O: Breathlessness/Orthopnoea PND: Paroxysmal Nocturnal Dyspnoea E: Excercise Intolerance F: Fatigue W: Weight Loss W: Wheeze M: Muscle Wasting C: Cold Peripheries
Heart Failure Symptoms: B PO F W/C MW
Heart Failure Symptoms: B: Breathlessness/Orthopnoea PO: Peripheral Oedema F: Fatigue W/C: Wheeze/Cough MW: Muscle Weakness
All Heart Failure Signs: E BP RV-H JVP F C C C HM T DA PA PO NPP 3HS W
Heart Failure Signs: Exercise Intolerance BP Low RV-Heave JVP - Raised Fatigue (Syncope) Crepitations Cyanosis Cold Peripheries Heart Mumurs Tachycardia Displaced Apex Pulsus Alternans *alternating strong and weak beats) Pulmonary Oedema Narrow Pulse Pressue 3rd Heart Sound Wheeze
Heart Failure Investigations: EEBBB MC R/M E E B B B
M
C
R/M
Heart Failure Investigations: EEBBB MC R/M
Echocardiogram (key)
ECG - VH, MI, Isc
BNP - Brain Natriuretic Peptide
Bloods - FBC, U & E, Glu
Biopsy - Endomyocardial
MRI
Chest X Ray - Alveolar oedema, Kerley B Lines, Cardiomegaly, Dilated Prominent Upper Lobe Veins, Pleural Effusion
RNVG/MUGA - Radionuclide Ventriculography/Multiple-Gated Acquisition Scan
Diagnosis of Heart Failure: Framingham Criteria
1 to 2 Major Criterion + 2 Minor Criterion
Major Criteria: ND,PO, C, S3G, CM, CVP, WL, JVP, HJR
Minor Criteria: NC, BAO, B/D, T, VC, PEf, Hm
Diagnosis of Heart Failure: Framingham Criteria
1 to 2 Major Criterion + 2 Minor Criterion
Major Criteria: Nocturnal Dyspnoea, Pulmonary Oedema, Crepitations, S3 Gallop, CardioMegaly, Central Venous Pressure raised, Weight Loss, Jugular Venous Pressure raised, Hepato Jugular Reflux
Minor Criteria: Nocturnal Cough, Bilateral Ankle Oedema, Breathlessness/Dyspnoea, Tachycardia, Vital Capacity reduced by 1/3 max, Pulmonary Effusion, Hepatomegaly
Heart Failure Treatment: AB, AN -> C or D
First Line:
Second Line:
Heart Failure Treatment:
First Line: ACE Inhibitors, Beta Blockers (Ramiprin & Bisoprolol)
Second Line: Aldosterone Antagonist with Nitrate (if persists give CRD (Cardiac Resynchronisation Defibrillator) or Digoxin
All Heart Failure Treatments: DAAS VVAD HB
Diruetic: Sprionolactone (K-Sparing) ACEI Angiotensin Receptor Blocker (ARB) Sacubitril Valsartan Ventricular Heart Devices Vasodilators Aldosterone Antagonist - Spironolactone Digoxin Heart Implants Beta-Blockers - only used when the patient has been stabilised - not used in acute setting.
HF Tx with Reduced Left Ventricular Ejection Fraction: First Line:
First Line: ACE Inhibitors, Beta Blockers (Ramiprin & Bisoprolol)
HF Tx & Influenza Treatment: (f)
Annually
HF Tx Spironolactone:
Only been shown to improve mortality in patients with Class 3 or 4 Heart Failure who are already taking an ACEI
Management Options in Acute HF: O LD O VD IA CPAP UF MCA
Management Options in Acute HF: Oxygen Loop Diuretics Opiates Vaso Dilators Inotropic Agents CPAP Ultra Filtration Mechanical Circulatory Assistance (Intra-aortic balloon counter-pulsation, or ventricular assist device.
