heart failure Flashcards
what is heart failure?
a syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the heart to function as a pump
What is ANP
it is a chemical secreted by atrial myocites in response to atrial stretch, this causes vasodilation, suppression of the renin angiotensin system and diuresis
What is BNP
a chemical produced by ventricles in response to increased myocardial wall stress
What is heart failure with reduced ejection fraction?
when the left side of the heart becomes thin and weak meaning the left ventricle is unable to eject adequate amount of blood during systole
What can cause heart failure?
- ischaemic heart disease
- valvular heart disease
- diabetes
- tachycardia arrhythmias
- hypertension
- dilated cardiomyopathy
- MI
What is heart failure with preserved ejection fraction?
this is when the myocardial stiffens, meaning less blood enters the LV
Symptoms of heart failure?
- shortness of breath (orthopnoea/when lying down and nocturnal)
- reduced exercise tolerance
- fatigue
- peripheral oedema
- wheeze
signs of heart failure?
- elevated JVP
- tachycardia
- hypotension
- ankle oedema
- third and fourht heart sounds, –bi basal crackles
- cyanosis
- displaced apex
What would Class I heart failure be according to the NYHA?
No limitation. Normal physical exercise does not fatigue, dyspnoea or palpitations
What would Class II heart failure be according to NYHA?
mild limitation. Comfortable at rest but normal physical activity produces fatigue, dyspnoea or palpitations
What would Class III heart failure be according to NYHA?
marked limitation. Comfortable at rest but light physical exercise causes marked symptoms of heart failure
What would Class IV heart failure be according to NYHA?
symptoms of heart failure occur at rest and are exacerbated by any physical activity
What investigations are taken place for heart failure?
Blood test using BNP as a marker
BNP>2000= urgent echo
BNP 400-2000= echo
BNP <400= not HF
ECG, XRAY- kerley B lines, cardiomegaly, pleural effusion, bat wings, perihilar congestion
MRI
-if <50% myocardium scarred consider revascularisation, if >50%= non viable
what is systolic failure/ heart failure with reduced ejection fraction?
-inability of the ventricle to contract normally, resulting in reduced ejection of blood (EF<40%)
what is diastolic failure/ heart failure with preserved ejection fraction?
-inability of the ventricle to relax and fill normally, causing decreased filling and reduced stroke volume (EF>50%)
