Heart Faure Classification System And BNP i Flashcards
What is the NYHA class 1?
No limitations
What is the NYHA class II?
Slight limitation where normal activit causes fatigue
What is the NYHA class III?
Marked limitation but comfort AT rest
What is the NYHA class IV?
Inability to carry any activity without discomfort and symptoms AT REST
BNP level for referral in 6 weeks?
400-2,000
BNP referral for urgent referral in 2 weeks?
Over 2,0000
BNP level for heart failure?
OVER 400
What is the management of heart failure?
ACE inhibitor and beta blocker
What is alternative to ACE-I or ARB for heart failure?
Hydralazine which is a vasodilator that reduces peripheral resistance
What improves mortality in diastolic heart failure?
No medication
What improves mortality in reduced ejection fraction?
BASH
Beta blockers
ACE inhibitors/ARB
Spironolactone
Hydralazine
What is the criteria for changing ACE inhibitor?
ACE inhibitors typically cause a small rise in creatinine. It must be MORE than 30% or FALL in GEFR of 25% to change.
When should assessment of renal function of ACE inhibitor be performed with change in enzymes?
Repeat blood test in 1-2 weeks
What medication should be added for reduced ejection fraction with persisting symptoms for ACE and beta blocker?
Spironolactone or eplerenone
What medication should be added for reduced ejection fraction with persisting symptoms for ACE and beta blocker?
Ivabradine
What medication should be added ideally for Afro-Carribean patients with persisting symptoms for ACE and beta blocker?
Hydralasaline and nitrate
What medication should be added ideally for atrial fibrillation patients with persisting symptoms for ACE and beta blocker?
Digoxin
What is a poor prognostic factor for heart failure?
Pulsus alter and indicating poor left ventiruclar function
Which drug causes gum hypertrophy?
Amlodipine Non-DHP CCB
Which drug can cause chest pain and weakness as side effect?
Doxazosin
Which drug causes constipation and headache?
Indapamide
What should be added if a patient has normal bP but ankle oedema?
Loop diuretics for fluid overload relief.
Beta blocker and CCB combination for heart failure?
Bisoprolol and Felodipine
-> must be non dihydropyridine to avoid additive risk of bradycardia and AV block
Causes of high output heart fialure
Less common ad caused by:
Anaemia
Pregnancy
Hyperthyroidism
Thiamine deficiency
Paget’s disease
Arteriovenous malformation
