Heart Failure, Myocarditis, Cardiomyopathies, and Pulmonary HTN II Flashcards
high output failure
normal heart
increased metabolic demand - thyrotoxicosis
excessive blood overwhelms ability of pump - anemia, AV fistula, beriberi, decreased PVR
crackles, wheezes, cough, blood tinged sputum, tachypnea, paroxysmal nocturnal dyspnea
left side failure
ascites, hepatomegaly, splenomegaly, JVP
right side failure
pulmonary edema
backward left heart failure
edema, ascites, end organ damage
right heart failure
nutmeg, liver, splenomegaly, GI sx
forward failure
mostly in left heart failure
hypotension, weakness, exercise intolerance, endo organ damage (ischemia)
NYHA
functional classification of HF
something used to be able to do, but now can’t
class I HF by NYHA
two flights of stairs
class II HF by NYHA
no dyspnea at rest with minimal activity
class IIIa HF by NYHA
dyspnea at rest with minimal activity
class IIIb HF by NYHA
symptoms at rest
class IV HF by NYHA
high risk, no structural heart disease
stage A
structural disease, no symptoms of HF
stage B
structure disease, with symptoms
stage C
refractory HF - requires specialized intervention
stage D
low BP, tachycardia, tachypnea, hypoxia
CHF
bilateral basilar crackles/rales
CHF
-higher up - worse
also dull on percussion, and tactile fremitus
parasternal lift
heave
RV enlarged
PMI displaced
LV enlarged
S3
heard with low EF
S4
diastolic dysfunction
positive in V1
right ventricular hypertrophy
BNP
bad test
high false positive
doesn’t rule out other causes of dyspnea
