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1st Year - Clinical Cardiovascular > Heart failure - treatment > Flashcards

Heart failure - treatment Flashcards

1
Q

What is the number one risk factor for heart failure

A

Hypertension

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2
Q

What are risk factors for heart failure

A 
Hypertension
Coronary Artery disease
Valvular disease
Alcholism
Infection
Diabetes 
Congenital heart defects
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3
Q

What is the viscous cycle created in systolic heart failure

A

Damaged heart loses frank starling
Body identifies drop of cardiac output
Increases Blood volume, HR and activates RAAS
This damages heart more and leads to more damage/fibrosis of heart

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4
Q

What 2 vital things is angiotensin II responsible for

A 
Peripheral vasoconstriction 
Aldosterone secretion (sodium reabsorption)
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5
Q

Why is an increase in aldosterone bad for heart failure patients

A

increase blood volume

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6
Q

What are the two general aims of heart failure treatment

A

improve symptoms

improve survival

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7
Q

What drugs can be used to improve symptoms

A

Furosemide or Bumetanide (diuretics)

Digoxin (positive ionotrope)

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8
Q

What drugs improve survival

A

Beta blockers

Ivabradine

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9
Q

Do beta blockers improve symptoms

A

NO

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10
Q

What detrimental hormonal changes can be blocked by drugs in heart failure

A

sympathetic activation
angiotensin II increase
aldosterone increase

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11
Q

What drugs block sympathetic activation on the heart

A

Beta blockers

Carvedilol, Bisoprolol, Metoprolol

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12
Q

What drugs block the conversion of angiotensin I to angiotensin II

A

ACE inhibitors

Ramapril and Perindopril

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13
Q

What drugs block angiotensin II acting on the AT1 receptor

A

Angiotensin II antagonists

Losartan, Valsartan

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14
Q

What drugs block aldosterone

A

Aldosterone antagonists:

Spironolactone

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15
Q

What does aldosterone do

A

H20 retention, vasoconstriction and sympathetic activation

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16
Q

What beneficial hormonal changes in heart failure can be enhanced with medication

A

The effects of Atrial natriuretic peptide and brain natriuretic peptide

17
Q

What do Atrial natriuretic peptide and brain natriuretic peptide do?

A

They are endogenously generated peptides activated in response to atrial and ventricular volume/pressure expansion.
ANP and BNP are released from the atria and ventricles, respectively, and both promote vasodilation and natriuresis

18
Q

What drug can be used to enhance BNP and ANP and how do they work

A

Neprolysin inhibitors

They stop the metabolism of ANP and BNP

19
Q

What drugs can be used to enhance cardiac function during heart failure

A 
Positive Ionotropes (Digoxin) 
Nitro vasodilators (Isosorbide moni or dinitrate)

1st Year - Clinical Cardiovascular (10 decks)

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