Heart failure Flashcards
What is heart failure?
Impaired ability of heart to increased cardiac output to meet physiological demand
What is the pathophysiology of heart failure?
Low cardiac output –> activation of RAAS and sympathetic system –> vasoconstriction and increased circulating volume –> more load on heart
What is the mechanism of Left heart failure causing complete heart failure?
Low output –> backup into pulmonary system –> pulmonary hypertension –> increased work on R heart –> R heart failure
How does R heart failure cause L heart failure?
Low output –> backup into systemic circulation –> hypertension –> increased work of L heart
What is th main cause of heart failure?
Ischaemic heart disease
What are some causes of heart failure?
IHD Valvulr disease Thyroid dysfunction Hypertension Infection Arrythmia Congenital defects Respiratory disease
What is the classification system used for heart failure?
NYHA
What ar the classifications of heart failure?
1= asymptomatic 2= slight symptoms on exertion 3= symptoms on daly tasks 4= symtoms at rest
What is the presentation of heart failure?
Dyspnoea, orthopnoea Cough- worse at night, pink frothy sputum Chest discomfort Tachycardia Peripheral oedema Cardiomegaly, displace apex beat Bibasal crackles Neck vein distension Hepatomegaly
What investigations are done for heart failure?
B natriuretic peptide ECG Echo CXR FBC, U&Es, LFTs
What are the outcomes of a raid BNP?
VEry= echo in 2 weeks Slightly= echo in 6 weeks
What are the principles of management of heart failure?
Lifestyle emasures
Essential medications
Adjuncts
What are some lifestyle measures used to teat heart failure?
Sodium and fluid restriction
Weight monitoring
Smoking cessation
What ar the essential medications in heart failure?
ACE inhibitor
Beta blocker
What are some adjunct medications used in heart failure?
Diuretics -spironolactone= 1st line -furosemide Digoxin Ivabradine
