Heart Failure Info Flashcards

0
Q

Right heart failure

A
Fluid buildup in abdomen
Ascites 
Fatigue
Anorexia
Enlarged liver and spleen
Swelling hands and fingers
Distended jugular veins
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1
Q

Left heart failure

A
Thin and weAk
Fluid buildup in lungs 
Kikexic
Increased PCWP
Cough
Fatigue
Tachycardia
Body not adequately perfused
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2
Q

Symptomatic definition of HF

A

Mismatch between right and left heart volume outputs

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3
Q

Cardio centric definition of HF

A

Hearts inadequate ability to fill with or eject blood

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4
Q

Systolic HF

A

Decreased contractility and EF

Use Batista procedure

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5
Q

Diastolic HF

A

Decreased ventricular filling and cardiac output

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6
Q

Options for CHF

A

Heart transplant, VAS, or death

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7
Q

Main HF causes

A
Ischemia
Idiopathic
Viral
Immune mediated
HTN
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8
Q

Ischemic HF

A

Most common (70%)

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9
Q

Viral HF

A

Viruses don’t primarily attack myocardium, errantly end up there
Can cause cardiomyopathy
May require valvular surgery

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10
Q

Forces contributing to worsening HF

A

SNS and PSNS

Renin angiotensin aldosterone system

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11
Q

Goals of HF therapy

A

Improve/alleviate symptoms
Slow downhill slide toward transplant/VaD/death
Improve survival
Increase QALYs

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12
Q

QALYs improving drugs

A
Positive inotropes
Diuretics
Renin/angiotensin blockers
Primary vasodilators
Beta blockers
Aldosterone antagonists
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13
Q

Positive inotropes

A

Cardiac glycosides
Cathecholamines
Bypiridiney

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14
Q

Digitalis MOA

A

Blocks Na/K pump

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15
Q

Nickname for bipyridines

A

Phosphodiesterase inhibitors

16
Q

Bipyridines action

A

Increase cAMP, increase Ca, increase contractility

Long term has high mortality!!! Only use on short term acute HF (pt struggling to come off bypass)

17
Q

Effects of diuretics

A

No direct effect on heart
Decreased preload, afterload, and edema
Net affect is decreased workload so decreased O2 demand

18
Q

Effects of ACE inhibitors

A

Decreased venous tone, decreased SVR, preload, afterload, and BP

19
Q

Patients intolerant to ACE inhibitors and ARBs respond to…

A

Hydralazine (Apresoline) and Isosorbide (Isordil)

20
Q

Effect of beta blockers

A

Block chronic SNS that leads to apoptosis and remodeling

Decreases O2 demand

21
Q

Beta blockers with long term HF survivability

A

Metoprolol (Lopressor, Toprol XL)

Carvedilol (Coreg)

22
Q

LCZ696

A

50/50 mix Losartan and Sacubitril

Nephrilysin inhibitor

23
Q

Stages of CHF

A

A: high risk, no symptoms (treat obesity, diabetes, HTN, etc)
B: symptom with severe exercise (ACE, ARB, diuretic, beta blocker)
C: symptoms with marked exercise (add digoxin, aldosterone antagonist, Hydralazine, nitrate)
D: severe symptoms at rest (LVAD, transplant)

24
Q

Best drug combination for CHF

A

Digoxin, diuretic, amd ACE inhibitor

25
Q

Effects of morphine

A

Lowers respiratory rate
Decreases preload and afterload
Eases anxiety