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phase 2 cardio > HF > Flashcards

HF Flashcards

1
Q

Define HF

A

Cardiac output inadequate for requirements

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2
Q

what is the incidence of HF

A

1-3% but 10% in elderly

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3
Q

what is the 5 year survival for HF

A

25-50%

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4
Q

what are the causes of HF

A
  • IHD 70% , Hypertension (5%)
  • Non-Ischaemic Dilated Cardiomyopathy (25%)
  • Other: valvular, congenital (VSD, ASD), AF, PE
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5
Q

what is the aetiological difference between mild, moderate and severe HF

A

Mild: ↓EF →↓CO and ↑HR
Moderate: ↑ venous pressure +↑HR= ↓CO
Severe: ↓CO even at rest

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6
Q

what is the cycle of heart failure

A

increased pre-load leads to increased cardiac work/myocardial damage leads to decreased CO which leads to RAAS activation that causes vasoconstriction and water retention leading to increased pre-load

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7
Q

Define congested HF

A

combination of L and F HF

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8
Q

define Systolic HF

A

: Ejection Fraction (EF)

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9
Q

define diastolic HF

A

: ↑ filling pressure with EF>50% i.e. tamponade HTN,

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10
Q

define High output HF

A

↑demand i.e. anaemia, pregnancy

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11
Q

define low output HF

A

failure to maintain CO

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12
Q

what are the main causes of Left HF

A
  • IHD,
  • Non-ischaemic dilated cardiomyopathy
  • Hypertension
  • Valvular: MS(HTN in RA)
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13
Q

what are the symptoms of L HF

A
  • Fatigue (common)
  • Exertional dyspnoea
  • Orthopnoea / PND
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14
Q

what are the signs of L HF

A
  • Apex displacement: cardiomegaly
  • 3rd heart sound: galop rhythm
  • Crackles in lung bases: Pulmonary oedema
  • Pitting oedema
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15
Q

what are the causes of R HF

A
  • Cor pulmonalis
  • PE, pulmonary hypertension
  • Tricuspid OR pulmonary valve disease
  • ASD, VSD
  • RV cardiomyopathy
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16
Q

what are the symptoms of R HF

A

• Fatigue, dyspnoea, anorexia, nausea

17
Q

what are the signs of R HF

A
  • ↑JVP
  • Cardiomegaly and functional tricuspid regerge
  • Hepatomegaly and ascitic
  • Pitting oedema
18
Q

what bloods would be useful in diagnosis of HF and why

A

↑BMP, FBC(anaemia), U&E (eGFR, ion stability), CVS ↑risk: Glucose (DM) Lipids, TFTs, LFTs (liver ascitis?)

19
Q

What other investigations are useful in assessing HF and why

A

• CXR: cardiomegaly, pleural effusion
• ECGO if BMP >400pg/ml
o LV function, valves diastolic function

20
Q

what factors other than HF raise naturetic peptide

A 
o	Chronic hypoxaemia 
o	Renal dysfunction 
o	Advanced age
o	Liver cirrhosis 
o	Sepsis
21
Q

What level on naturetic peptide warrens ECHO

A

> 100pm/ml

22
Q

what is the NYHM scale of HF

A

classification of disability due to HF

23
Q

what is class I NYHA

A

No limitation of physical activity

24
Q

what is class II NYHA

A

Slight limitation of physical activity (symptomatically mild heart failure

25
Q

what is class III NYHA

A

Marked limitation of physical activity (symptomatically moderate heart failure)

26
Q

what is class IV NYHA

A

Symptoms at rest (symptomatically severe heart failure)

27
Q

What lifestyle changes are recommended in HF

A
  • ↑exercise, ↓salt, stop smoking & alcohol
  • Travel advice
  • Cardiac rehab
28
Q

What medications are people with HF expected to be taking

A
  • Diuretics: 1st lien furosemide (40mg); 2nd line bumetanide 3rd line add thiazide
  • ACEi & β-blocker: LVEF
29
Q

what is the specific management of LVHF

A
  1. ACEi and β-blocker
  2. Replace ACEi with ARB 2nd line
  3. Specialist
    a. Spirolactone
    b. Digoxin=> sever HF
30
Q

what are the Surgical management options for HF

A
  • Revisualisation: due to angina

* Devices: pacemaker (CRT) and defibrillator (ICD)

31
Q

what is the palliative management in HF

A
  • Treat/prevent co-morbidities
  • Good nutrition/allow alcohol
  • Control: Dyspnoea, Pain => from liver capsule stretching, Nausea, Constipation, ↓mood/depression
32
Q

what is the management of acute HF

A
  • ABCDE: Oxygen

* Diuretics, β-blockers, ACEis

phase 2 cardio (5 decks)

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