HTN + HF

Question 1

Acute Pulmonary Oedema

Answer 1

Fall in CO > Rise in LVEDP > Increased Pulm vascular pressure > EDP rises above lymphatic drainage > Fluid accumulates in interstitium +/- alveoli.

Causes: acute ischaemia, AF/flutter/VT, papillary muscle rupture

Clinical features:
- pink frothy sputum, PND, orthopnoea, cyanosed, accessory muscles
X ray findings: Kerley B lines

• Treatment:
• Morphine, O2, IV diuretic, Nitrate

Question 2

Acute on Chronic HF

Answer 2

LV pump failure > fall in BP > sympathetic activation > ↑ afterload

LV pump failure > ↓ renal perfusion > RAAS activation > ↑ pre load