Heart failure - Pathophysiology Flashcards
What is heart failure?
-Clinical syndrome composed of dysponea, fatigue, fluid retention due to cardiac dysfunction either at rest or upon exertion.
Types of heart failure
- heart failure due to LVSD due to IHD
- HF due to severe aortic stenosis
State the symptoms of heart failure
- breathlessness
- fatigue
- oedema
- reduced excercise capacity
State the clinical signs of heart failure
- oedema
- tachycardia
- raised JVP
- chest ctepitations or effusions
- 3rd heart sound
- displaced/abnormal apex beat
Symptoms are nonspecific
Investigation of heart failure
- echocardiography
- radionuclide ventriculography
- MRI
- left ventriculography
- LV ejection fraction?
Screening tests for heart failure
- 12 lead ECG
- BNP
12 Lead ECG
-LVSD unlikely if ECG is normal
BNP ( brain natriuretic peptide)
- amino acid peptide measured in blood
- high in HF, if so ECHO/cardiac assestment
- stable up to 72 hours.
- bedside testing available
What are the causes of systoliregurgitationd dysfunction
-IHD
Dilated cardiomyopathy ( means LVSD not due to IHD/secondary to other lesions)
- Inherited, toxins viral ( myocarditis, chronic DCM), systemic disease ( sarcoidosis, haemachromatis, SLE, mitochondrial dis), muscular dystrophies, peri partum , hypertension, etc
-severe aortic valve disease or mitral
LV ejection fraction severities
normal 50-80%
mild 40-50%
moderate 30-40%
severe <30%
Biplane modifies simpron’s rule
- divides LV cavity into multiple slices known ( thiclness/diameter)
- volume of each slice = areaXthickness
- thinner slcies > more accurate volume estimated
- endocardial border accurately
LVEF - MUGA
-onising radiation
Treatment of HF
- diuretics
- ACE inhibitors/ARBs
- Betablockers
- aderesterone receptor blockers
- ARNIs: angiotensin receptor neprilysin inhibitors
