Heart Failure Treatment Flashcards
Describe LV systolic dysfunction.
Decreased pumping function of the heart, which results in fluid back up in the lungs and heart failure
Describe LV diastolic heart failure
Involves a thickened and stiff heart muscle
As a result, the heart does not fill with blood properly
This results in fluid backup in the lungs and heart failure
What can hypertension can lead to diastolic function which can then lead to…?
Systolic dysfunction
What can MI lead directly to concerning to LV?
Damage to the left ventricle and systolic dysfunction
What does heart failure usually occur as a result of? (2)
Prolonged hypertension
MI
What type of issues can prolonged hypertension lead to regarding HF?
Diastolic Dysfunction /Preserved ejection fraction HF
Progresses to reduced ejection failure systolic dysfunction
What issue can a MI lead to regarding HF?
Systolic Dysfunction
What can happen as a result to damage of the ventricle?
Cardiac output falls
Body registers this as a loss in circulatory volume so activates the sympathetic system and the renin-angiotensin-aldesterone system.
Which two systems become activated upon damage to the ventricle?
Sympathetic system
RAAS system (renin-angiotensin-aldesterone system).
What does activation of the sympathetic system lead to?
Vasoconstriction
What does activation of the RAAS lead to?
Salt and water retention
What happens as a result to sympathetic vasoconstriction?
Increased afterload
What happens as a result to RAAS salt and water retention?
Increased circulatory volume
What can increased circulatory volume lead to in terms of the heart?
As circulatory volume increases the heart dilates, the force of contraction weakens and cardiac output drops further
This leads to further activation of the sympathetic and RAAS systems hence starting a vicious cycle
What are the aims of HF treatment?
Improve symptoms
Improve quality of life
Prevent hospital admission
Reduce mortality rates
Which drug can be given o those w HF to reduce symptoms for those with water and salt retention?
Furosemide, a type of loop diuretic
What drugs are used if a patient develops resistance to loop diuretics?
Use loop in combination with thiazide diuretics
There are several adverse drug reactions to diuretics.
What are some of the adverse reactions to loop diuretics if used in excess?
Dehydration
Hypotension
Hypokalaemia, Hyponatraemia
Gout
Impaired glucose tolerance, diabetes
List some groups of drugs which are Neuro-hormonal Antagonists.
ACE Inhibitors
Beta receptor blockers
Mineralocorticoid Receptor Blockers
Combined angiotensin blockade plus ANP/BNP enhancement
RECAP- which system do ACE inhibitors block?
RAAS
RECAP- give some examples of CAE inhibitors.
Ramipril
Enalapril
Lisinopril
What affect do ACE inhibitors have?
Block angiotensin converting enzyme which prevents conversion of angiotensin 1 to angiotensin 2.
Reduces preload and afterload.
What are some of the adverse drug reactions to ACE inhibitors?
Cough
Angioedema
Renal impairment
Renal failure
Hyperkalaemia
Which drugs can ACE inhibitors interact with?
NSAIDS - leading to acute renal failure
Potassium supplements - leading to hyperkalaemia
Potassium sparing diuretics - leading to hyperkalaemia
