Heart Failure Assessment Flashcards
How do we assess HF?
-risk factors
-documentation and history of HF symptoms
-physical examination
-obtain laboratory and other diagnostic tests to acertain the severity of disease
-determine the type of cardiac dysfunction ( systolic or diastolic)
-determine the aetiology to see if this is controllable/reversible process
Name some risk factors for HF
unhealthy behaviours:
-sedentary lifestyle, sodium and fluid, alcohol and drug abuse
Already having a disease that damages the heart:
-CHD, hypertension, valvular heart disease, infections, HF caused by chemotherapy, pregnancy
What is the pain assessment model?
SOCRATES
s-SITE (where is the pain)
o- ONSET ( what were you doing when it started)
c-CHARACTER( what does the pain feel like)
r-RADIATES ( does the pain go anywhere else)
a- ASSOCIATED SYMPTOMS (nausea vomiting)
t- TIME (how often does it happen/ how long have they had it)
e-EXACERBATING/RELIEVING FACTORS ( does anything make it better or worse)
s-SEVERITY ( get an initial pain score)
What do we look for in a visual assessment for HF?
-chest pain- socrates
-dyspnoea- exertional/orthopnea/PND/Socrates
-palpitations- regular/irregular
-syncope - dizziness/black out/ close to black out
-oedema-pedal/ascites/pulmonary
-systemic symptoms- fatigue/fever
What is a BNP/NT- pro-BNP test?
-hormone that helps regulate blood volume
-maining released from the LV when the LV is stretched and having to work harder
-checks for HF
-if diagnosis is unclear it helps to differentiate HF from other conditions
-increases as HF develops but decreases if the condition has stabilised
if BNP> 2000ng/L - refer to a specialist unit for echo within 2 weeks
if 400-2000ng/L refer within 6 Weeks
-interventions can decrease levels
What is CPET?
defines the maximum excersise capacity through measurement of peak oxygen uptake ( VO2)
What are the rules for suspected HF?
-suspected HF
-do a 12 lead ECG and BNP test where available
-if both are normal HF is unlikely
-if one or more is abnormal use ECHO and look for abnormalities
What are some differential diagnosis to HF?
-obesity
-chest disease
-venous insufficency in lower limbs
-drug induced ankle swelling
(dihydropyridine calcium channel blockers)
-drug- induced fluid retention ( NSAIDS)
-hypoalbuminaemia
-intrinsic renal or hepatic disease
-pulomary embolic disease
-severe anemia or thyroid disease
-bilateral renal artery stenosis
