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Cardio > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

What is the definition of heart failure?

A

Inability of the heart to deliver blood and oxygen at a rate equal to the requirements of the metabolising tissues, despite normal or increased cardiac filling.

The syndrome of breathlessness, tiredness and fluid overload caused by a form of cardiac function. Needs to have the cardiac dysfunction to mean heart failure.

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2
Q

In general what can be the result of heart failure?

A

Can ba as a result from any structural or functional cardiac disorder that impairs the heart’s ability to function and meet the demands of supplying sufficient oxygen and nutrients to the metabolising body.

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3
Q

Apart from ischemic heart disease what are some other causes of cardiac dysfunction?

A
  • Hypertension
  • Alcohol excess
  • Cardiomyopathy
  • Valvular
  • Endocardial
  • Pericardial causes
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4
Q

What categories can heart failure be divided into?

A

Systolic vs diastolic and acute vs chronic

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5
Q

What is systolic heart failure?

A

Inability of the ventricle to contract normally resulting in a decrease in cardiac output.

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6
Q

What can cause systolic heart failure?

A
  • Ischaemic heart disease
  • Myocardial infarction
  • Cardiomyopathy
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7
Q

What is diastolic heart failure?

A

Inability of the ventricles to relax and fill fully thereby decreasing stroke volume and decreasing cardiac output

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8
Q

What can lead to diastolic heart failure?

A
  • Hypertrophy of the ventricles resulting in there being less space for the blood to fill in and therefore the cardiac output decreases
  • Aortic stenosis - increases afterload and thus decreased cardiac output
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9
Q

What is acute heart failure?

A

New onset of decomposition of chronic heart failure characteristized by peripheral of pulmonary oedema with or without the presence of peripheral hypotension

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10
Q

What is chronic heart failure?

A

Develops slowly. Venous congestion is very common but arterial pressure is sustained usually until late on.

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11
Q

What does HFREF and HFPEF mean?

A

Heart failure with reduced ejection fraction and heart failure with preserved ejection fraction

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12
Q

Why are men more susceptible to heart failure than women?

A

Because they don’t have the protective oestrogen

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13
Q

What are the three cardinal symptoms involved in the presentation of heart failure?

A
  1. Shortness of breath
  2. Fatigue
  3. Ankle swelling
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14
Q

Give 5 signs of heart failure?

A
  1. Tachycardia
  2. Displaced apex beat
  3. Added heart sounds
  4. Ascites
  5. Peripheral Oedema and sacral oedema (non specific)
  6. Pulmonary oedema causing bi-basal crackles
  7. Raised JVP
  8. Cyanosis
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15
Q

What are 3 symptoms of heart failure?

A
  1. SOB
  2. Fatigue
  3. Cold Peripheries
  4. Increased weight
  5. Orthopnea (SOB when lying down = need to sleep sitting up)
  6. Paroxysmal nocturnal dyspnea - ONLY IN HF AND MITRAL VALVE DISEASE
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16
Q

What classification system is used to classify heart failure?

A

The New York Heart Association (NYHA) classification

17
Q

What is class I heart failure?

A

No limitation (asymptomatic) - exercise = no fatigue, dyspnoea or palpitation - these people will probably die early but are a lot better off than the class IV’s

18
Q

What is class II heart failure?

A

Slight limitation (mild HF (heart failure)) - comfortable at rest, normal activity = fatigue, dyspnoea and palpitations

19
Q

What is class III heart failure?

A

Marked limitation (moderate HF) - comfortable at rest, gentle activity = fatigue, dyspnoea & palpitations

20
Q

What is class IV heart failure?

A

Inability to carry out any physical activity without discomfort (severe HF) - symptoms occur at rest - these are the worst

21
Q

What is the main marker in a blood test that is released in heart failure?

A

Brain natriuretic peptide (BNP)

  • Secreted by ventricles in response to increase myocardial wall stress
  • Increased in patients with heart failure
  • Levels correlate with ventricular wall stress and the severity of heart failure
22
Q

What could the chest xray show in heart failure?

A
  • Alveolar oedema
  • Cardiomegaly
  • Dilated upper lobe vessels of lungs
  • Effusions (pleural)
23
Q

What are non-pharamacological treatments in heart failure?

A
  • Avoid large meals
  • Lose weight
  • Stop smoking
  • Exercise
  • Vaccination
24
Q

How would you treat the symptoms of congestion in heart failure?

A

With diuretics

25
Q

How do diuretics work?

A
  • Promote sodium and thus water loss thereby reducing ventricular filling pressure (preload) decreasing systemic and pulmonary congestion
  • Aldosterone antagonist (thereby inhibiting ADH release resulting in water loss)
26
Q

What are the two first line pharmacological treatments for heart failure?

A

ACE inhibitors and beta blockers

27
Q

With what condition are beta blockers contraindicated?

A

Asthmatics

28
Q

What are the side effects of ACE inhibitors?

A
  • Cough
  • Hypotension
  • Hyperkalaemia
  • Renal dysfunction
29
Q

What can be given instead of an ACE inhibitor?

A

ARB

30
Q

What is the surgical management for heart failure?

A
  • Revascularize with stenting

- Repair e.g mitral valve repair

Cardio (9 decks)

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