Heart Failure Flashcards

1
Q

How does heart failure most commonly arise?

A

When cardiac output is low (many causes), body thinks fluid is low and so retains fluid, causing fluid overload, thus the heart has to work harder (and often can’t)

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2
Q

What are the main causes of left sided heart failure?

A

Ischaemic heart disease (MI etc.)
Cardiomyopathies
Valvular disease

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3
Q

How do numerous MIs lead to heart failure?

A

Scar tissue is left resulting in reduced contractility, so cardiac output decreases

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4
Q

What are the main causes of right sided heart failure?

A

Secondary to left heart failure
Cor pulmonale
Congenital defects

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5
Q

How does cor pulmonale cause heart failure?

A

Lung disease causes hypoxia, resulting in pulmonary vasoconstriction, causing increased back pressure, so right heart has to work harder and often fails

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6
Q

What are the main symptoms of left heart failure?

A

Dyspnoea on exertion/rest
Orthopnoea
PND
Pink, frothy sputum (pulmonary oedema)

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7
Q

What are the main signs of left heart failure?`

A
Tachycardia
Crepitations
Pleural effusion
S3
Cardiomegaly, bats wings on CXR
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8
Q

What are the main symptoms and signs of right heart failure?

A

Ankle swelling
Raised JVP
Hepatomegaly
Ascites

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9
Q

What are the main drugs used for heart failure?

A
Loop diuretics
ACEi
B blockers
Spironolactone
Digoxin
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10
Q

What invasive therapy can be used to treat heart failure?

A

Implantable defibrilators

Cardiac resynch therapy

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11
Q

What does cardiac resynch therapy achieve?

A

If both sides of heart contracting at different times (slight delay), CRT minimises this gap to improve cardiac efficiency

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12
Q

What is the unwanted effect of furosemide?

A

Hypokalaemia

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13
Q

How might hypokalaemia be corrected in heart failure treatment?

A

Use furosemide in conj with ACEi/spironolactone - these cause hyperkalaemia

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14
Q

What type of drug is spironolactone?

A

Aldosterone antagonist

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15
Q

How does left ventricular failure cause pulmonary oedema?

A

LV failure cause LA pressure to rise, causing back pressure on the lungs which increases pulmonary capillary hydrostatic pressure, causing fluid to accumulate in the pleural space

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