Heart Failure High Yield Handout Flashcards
AHA define HF as
a complex clinical syndrome that results from
structural or functional impairment of ventricular
filling or ejection of blood
leads to the cardinal clinical symptoms of dyspnea
and fatigue and signs of HF, namely edema and
rales.
Because many patients present without signs or
symptoms of volume overload, the term “heart
failure” is preferred over the older term
“congestive heart failure.”
Stage A HF
at high risk for HG but without structural disease of symptoms
HTN/Atherosclerotic disease/Diabetes/Obesity/Metabolic Syndrome
Stage B HF
structure heart disease but without signs or symptoms of HF
Previous MI/LV remodeling/LVH and low EF/asymptomatic valvular disease
Stage C HF
structural heart disease with prior or current symptoms
Known structural Heart Disease/ and SoB with fatigue/reduced exercise tolerance
Stage D HF
Refractory HF requiring specialized intervention
Pts with marked symptoms at rest despite maximal medical therapy
NYHA class I
no limitations of physical activity.
Ordinary physical activity does not cause undue breathlessness, fatigue, or palpitations
NYHA class 2
Slight limitations of physical activity. Confortable at rest, but ordinary physical activity results in undue breathlessness, fatigue, or palpitations
NYHA class 3
Marked limitations of physical activity. Comfortable at rest, but less than ordinary physical activity results in undue breathlessness, fatigue, or palpitations
NYHA class 4
Unable to carry on any physical activity without discomfort. Symptoms at rest can be present. If any physical activity is undertaken, discomfort is increased
how is diagnostics of HF made
thorough history and physical examination
Diagnostic data for HF
CBC CMP Cardiac Enzymes UA BNP
echo with doppler and chest x-ray
5 signs to look for in chest x-ray
alveolar oedema (bat's wings) prominent upper lobe vessels cardiomegaly pleural effusion Kerley b lines (interstitial edema)
Major criteria
Paroxysmal nocturnal Dyspnea Orthopnea Elevated jugular venous pressure crepitations third heart sound radiological evidence of cardiomegaly radiological evidence of pulmonary edema
Minor criteria
extermity edema night cough exterional dyspnea hepatomegaly pleural effusion HR >120 loss of 4.5kg in 5 days following diutetic treatment
Osteopathic concern, parasympathetic
increased tone bradycardia
vagal stimulation
OA AA C2
Osteopathic concern, tender points for parasympathetic
tissue changes over cervical pillars
rotated vertebrae
compression of occipitomastoid sutures as well as occipito-antlantoid joint
Osteopathic concern sympathetic
increased tone, tachycardia
T1-5
Osteopathic concern tender points for sympathetic
tissue changes over TV
rotated vertebrae
Osteopathic concern motor
C3-C5 phrenic nerve
Osteopathic concern motor tender points
tissue texture changes over cervical pillars
rotated vertebrae
Osteopathic concern motor other SD
Dependent extremity edema
Rib dysfunction
Flattened diaphragm
Scalene hypertonicity and tender points
Pectoralis minor hypertonicity and tender points
2 minute treatment OMM
petal pump
5 minute treatment OMM
rib raising
extended treatment OMM for head
OA release or V spread for vagus
CV4 hold if CRI decreased
extended treatment OMM for abdomen
diaphragm doming technique
extended treatment OMM for thoracolumbar junction
ME
MFR
HVLA
extended treatment OMM for thoracic
MFR
extended treatment OMM for rib dysfunction
ME
extended treatment OMM for cervical
C2
C3-5
MFR, ME, FPR
extended treatment OMM for UE and LE
effleurage
extended treatment OMM for cervical-scalense
CS or ME
extended treatment OMM for UE - pec minor
C5
ME
abdomen or other viscerosomatic
chapman’s reflex for heart
