Heart Failures Flashcards
What is HF
Clinical syndrome with symptoms and signs caused by structural/functional cardiac abnormality and corroborated by high natriuretic peptide levels and/or evidence of pulmonary or systemic congestion
Typical symptoms of heart failure
Breathlessness
Orthopnea
PND
reduced exercise tolerance
Fatigue, tiredness
Increased recovery time after exercise
Ankle swelling
Less typical symptoms of HF
Nocturnal cough
Wheezing
Bloated feeling
Loss of appetite
Confusion
Depression
Palpitation
Dizziness
Syncope
Bendopnea
Specific signs of HF
Elevated JVP
Hepatojugular reflux
Third heart sound
Laterally displaced apex beat
Less specific signs of HF
Weight gain
Weight loss when advanced
Cachexia
Cardiac murmur
Peripheral edema ( sacral , pedal )
Crépitations
Pleural effusion
Tachycardia
Irregular pulse
Cheyne stokes respi
Hepatomegaly
Ascites
Cold extremities
OLiguria
Narrow pulse pressure
Type of HF
LVF
RVF
CHF
LHF main symptoms and signs
Dyspnoea
Fatigue
Orthopnea
PND
pulmonary edema
RHF symptoms and signs
Edema
Elevated JVP
tender hepatomegaly
Hepatojugular reflux
What is class I HF
No limitation of physical activity
No symptoms on ordinary physical activity
What is class II HF
Slight limitation of physical activity
Comfortable at rest
Breathlessness, fatigue, palpitations on ordinary physical activity g
What is class III HF
Marked limitation of activity
Comfortable at rest
Symptoms present when less than ordinary physical activity
What is class IV HF
discomfort in any form of activity
Symptoms at rest
Increased discomfort on activity
Characteristics of left heart failure
Reduced left ventricular output
Increased left atrial and pulmonary venous pressure
Characteristics of right heart failure
Reduced right ventricular output
Increased right atrial/pulmonary venous pressure
What is systolic heart failure
Pumping problem
Reduced ejection fraction and enlarged ventricles.
Presents with left ventricular failure and marked cardiomegaly.
What is diastolic heart failure
Filling problem
Increased resistance to filling due to increased filling pressure.
Presents with pulmonary congestion with normal or slightly enlarged ventricles.
What is heart failure with reduced ejection fraction
Heart failure with reduced ejection fraction
EF <40%
Concomitant systolic and diastolic dysfunction
What is heart failure with preserved ejection fraction
Heart failure with preserved ejection fraction
EF>40%
Seen in diastolic dysfunction.
What is high output heart failure
Cardiac output is higher than normal due to increased peripheral demand
less common
Causes of high output cardiac failure
Anemia, hyperthyroidism , pregnancy, obesity, arteriovenous shunt , lung diseases…
What is low output heart failure
Reduced cardiac output due to reduced pumping activity of the heart
Reduced EF with end organ hypoperfusion
less common
Risk factors of heart failure
Predominant in the elderly population. ( >70 years old )
Obesity
Alcoholism
Smoking
High cholesterol
Hypertension
Diabetes
Valvular heart disease
Coronary heart disease
Cardiomyopathies
Viral infections
Congenital heart defects
