Heart Failure as a Drug Target Flashcards
What is heart failure?
An inability of the heart to pump blood effectively around the body - Can’t meet the body’s need.
What are the symptoms of heart failure?
Shortness of breath.
Fatigue.
Swelling.
What is left sided heart failure?
The left ventricle DOES NOT pump efficiently and therefore, prevents body from getting enough O2 rich blood.
This causes a fluid build up in the lungs.
What are the symptoms of left sided heart failure?
Breathlessness.
Pink sputum whilst coughing.
What is right sided heart failure?
There is NOT enough pumping of blood to the lungs as normal.
This causes a fluid build up in the legs.
What are the symptoms of right sided heart failure?
Heavy painful legs.
Difficulty walking.
Skin infections.
Pitting Oedema.
What is a ‘Pitting Oedema’?
When you place a thumb on your leg -> there would be a depression where the thumb was.
This is due to the oedema build up in the legs.
What is congestive cardiac failure?
This is a failure of both sides of the heart due to fluid build up AROUND the heart -> Affects pumping power of the heart.
What are the places where fluid build up is common in heart failure patients?
Lungs
Abdomen
Liver
How many stages are there in congestive cardiac failure?
4 stages.
What are the 2 main ways of measuring heart failure?
BNP
Echocardiogram
What is BNP?
Brain Natriuretic Peptide.
How is a BNP test done?
Blood is drawn up from the veins (Known as a venipuncture).
What is the ‘abnormal level’ for a BNP test?
Greater than 100pg // ml is abnormal.
What is an indicator of a high BNP score?
Heart failure is of a great risk.
How is more BNP released?
More stretch in the heart vessels results in more BNP being released and this depicts that the heart is being put under immense pressure.
How can an ECG show heart failure?
There is a DILATED left ventricle (alongside mitral regurgitation) and thus, there is increased pressure which can lead to heart failure.
What is mitral regurgitation?
This is the leakage of blood back through the mitral valve each time the left ventricle contracts.
What is cardiomyopathy?
This is when the muscle is TOO THIN and therefore, can’t contract due to weak forces and pressure.
What is cardiac hypertrophy?
Muscle is TOO THICK because it can’t contract and thus filling of the heart with blood doesn’t occur properly.
What is the ejection fraction like with cardiomyopathy?
Reduced ejection fraction.
What is the ejection fraction like with cardiac hypertrophy?
Preserved ejection fraction.
What are the causes of heart failure?
Ischaemic heart disease Hypertension Valve Disease Cardiomyopathy Atrial Fibrillation
What is preload?
Initial stretching of cardiac myocytes prior to the contraction.
What is preload like during heart failure?
This is elevated due to ventricular dilation and increased blood volume.
How can preload be reduced?
Loop Diuretics = Furosemide
Aldosterone Antagonist = Spironolactone
How can loop diuretics reduce preload?
Acts on the Na+ // K+ // 2Cl- symporter in the thick ascending limb of the loop of Henle.
How can aldosterone antagonist reduce preload?
Decreases sodium reabsorption.
What is afterload?
Pressure the heart must work against in order to eject blood during systole.
How can you reduce afterload?
ACE inhibitors = Ramipril
Calcium Channel Blockers = Amlodipine
What is rate control?
This is slowing the heart down = Improving the ejection fraction.
How do you reduce the heart rate?
Beta Blockers // Calcium Channel Blockers.
What is rhythm control?
Improving heart efficiency can improve the symptoms.
How do you improve heart rhythm?
Beta Blockers are used.
Digoxin can be added on at the end.
