HF/Afib Flashcards
HF with reduced EF
≤40%
HF with preserved EF
≥50%
borderline: 41-49%
improved >40%
ACCF/AHA Stages of HF
A. at risk for HF but without structural heart disease or symptoms of HF
B. Structural heart disease but without s/s of HF
C. Structural heart disease with prior to current symptoms of HF
D. Refractory HF requiring specialized interventions
NYHA Functional Classification of HF
- No limitation in physical activity
- Slight limitation. Comfortable at rest, but ordinary physical activity results in symptoms of HF
- Marked limitation. Comfortable at rest but less than ordinary physical activity results in symptoms of HF
- Unable to carry on any physical activity without symptoms of HF or symptoms at rest
HFpEF treatment
diuresis to relieve symptoms of congestion
follow guideline driven indications for comorbidities
HFrEF treatment medications
-diuretic -loop preferred
-ACE
-Beta-blocker- meoprolol succinate, carvedilol, or bisprolol only
-Adlosterone antagonist - spironoloactone indicated for EF < 35%
-Sacubitril/valsartan
-hydralazine/isosorbide dinitrate- for african americans
Digoxin indication
symptomatic management not responsive to diuretics or ACE-inhibitors
Digoxin monitoring
renal function, drug levels, electrolytes
Digoxin toxicity symptoms
GI upset, blurred/yellow vision, arrhythmias
Digoxin drug interactions
-verapamil
-amiodarone, dronedarone
-clarithromycin, erythromycin
Class 1 antiarrhythmic agents
-rhythm
-quinidine, lidocaine, flecainide
Class 2 antiarrhythmic agents
-rate
-B-adenergic blockers- propranolol, sotalol
Class 3 antiarrhythmic agents
-rhythm
-amiodarone, dronedarone, dofetilide
Class 4 antiarrhythmic agents
-rate
-calcium channel blocker- verapamil, diltiazem
Other antiarrhythmic agent
-digoxin
