Heart Failure - Classification Flashcards
Risk Factors
- Ischemic Heart Disease
- Valvular Disease
- Atrial Fibrillation
- Myocardial Infarctio
- Hypertension
- Diabetes
- Hyperlipidemia
- Heavy Alcohol Use
- Substance Use
- Smoking
- COPD
- Chemotherapy
- Family history of cardiomyopathy
Medications that cause Heart Failure
- NSAIDs
- Corticosteroids
- Gabapentinoids
Heart Failure
- Natriuretic Peptides what
Secreted in response to pressure or volume overload
Natural biomarkers for HF
- B-Type Natriuretic Peptides (BNP)
- NTproBNP (N Terminal pro-hormone BNP)
Heart Failure
- Natriuretic Peptides use
Can be used for:
- Diagnosis
- Prognosis
- Risk stratification
- Monitoring heart failure
Can rule out HF, but, can not establish HF on its own
Heart Failure
- BNP Diagnosis
All Ages
- < 100 = Unlikely
- 100 - 500 = Possible
- > 500 = Likely
Heart Failure
- NT-proBNP
Less than 50
< 300 = Unlikely
300 - 450 = Possible
> 450 = Likely
50-75
< 300 = Unlikely
300 - 900 = Possible
> 900 = Likely
Older than 75
< 300 = Unlikely
300 - 1800 = Possible
> 1800 = Likely
Left Ventricular Ejection Fraction
Heart Failure with Reduced Ejection Fraction
- HFrEF
- HF with LVEF < 40%
Heart Failure with Mildly Reduced Ejection Fraction
- HFmrEF
- HF with LVEF < 41 - 49%
Heart Failure with Preserved Ejection Fraction
- HFpEF
- HF with LVEF > 50%
Heart Failure
- Stage C
Symptoms of HF
and/or
Signs of HF caused by structural / functional cardia abnormality
Heart Failure = Signs/Symptoms + LV Dysfunction
Advanced Heart Failure
- Stage D
Severe symptoms
and/or
Symptoms at rest
Despite therapy or intolerant to therapy
HFref
- What is it
LVEF < 40% (Volume Overload)
- Fluid is not pushed out causing it to build up
HFrEF
- Patient Profile
Young male post MI
HFrEF
- Clinical Features
- AF
- CAD
- Cerebrovascular Disease
- Diabetes
- Hypertension
- Lipidema
- Prior MI
HFrEF
- Cardiac Structure
- Eccentric hypertrophy
- Increased left ventricular mass
- Rounding of heart structure
HFrEF
- Clinical Outcomes
CV Mortality
Hospitalization for HF
HFPef
- What is it
LVEF > 50% (Pressure Overload)
- Using a lot of pressure to pump blood
- Heart muscles may be thicker due to underlying hypertrophy creating more resistance
HFpEF
- Patient Profile
Older female
HFpEF
- Clinical Feature
- AF
- CAD
- CKD
- Diabetes
- Hypertension
HFpEF
- Cardiac Structure
- Increase in Left Atrial Size
- Concentric LV remodeling
- Concentric hypertrophy
- Elevated LF filling pressure
HFpEF
- Clinical Outcomes
Non-CV causes of death
Classification of Heart Failure
- Low vs High Output
Low Output:
- Metabolic demands are normal but heart is not able to meet them
High Output:
- Metabolic demands are increased and heart is not able to meet them
Classification of Heart Failure
- Left, Right, Bi
Left Sided
- When blood is not adequately pumped from left ventricle
Right Sided
- When blood is not adequately pumped from right ventricle
Biventricular
- Left + Right
