HTN/HF Flashcards
What are DDx for HTN + SOB
CHF Renal failure PE/DVT Liver dz A. fib.
When may BNP be diagnostic? otherwise what is it used for?
When a pt has a new onset of SOB Used as a prognosis tool
What imaging is recommended in a pt who presents with CHF?
- CXR if new onset, or acute 2. ECHO for inital eval 3. EF in pts with change in clinical status or had tx that may affect cardiac function
What may a CXR of a pt with CHF show?
B/l basal congestion Pleural effusion Cardiomegaly hilar congestion
Describe Systolic Dysfunction
HF w/ decreased or impaired EF (HFrEF) < 40 %
Describe Diastolic Dysfunction
Diastolic HF w/ normal or preserved EF (HFpEF) > 50 %
How is stage A HF described by the ACFF/AHA?
High risk for HF w/o structural heart dz or sx
How is stage B HF described by the ACFF/AHA?
Structural heart dz w/o s/s of HF
How is stage C HF described by the ACFF/AHA?
Structural heart dz w/ prior or current sx of HF.
How is stage D HF described by the ACFF/AHA?
Refractory HF requiring specialized interventions
How is class I HF described by the NYHA
(Mild): No limitations, asymptomatic
How is class II HF described by the NYHA
(Mild): Slight limitation w/ physical activity, sx w/ ordinary activities, comfortable at rest
How is class III HF described by the NYHA
(Moderate): Marked limitation; symptomatic with less than ordinary activities, comfortable at rest
How is class IV HF described by the NYHA
Unable to carry on any physical activity w/ sxs, sx at rest
Stage C is usually associated with class __ and ___ from the NYHA
2, 3
Stage D is mostly defined as ___ from the NYHA
4
What is considered risk actors for HF?
HTN Atherosclerotic dz DM obesity Met. syndrome
What can cause structural heart dz and may/may not cause sxs?
MI LVH Valvular dz
What are the goals of therapy and Tx for a pt with Stage A HF?
GOAL: Lifestyle changes TX: fix RFs (ACE/ARB, statins)
What are the goals of therapy and Tx for a pt with Stage B HF?
GOAL: Prevent HF sxs and further structural damage TX: ACEI/ARB, BB, Statins
What are the goals of therapy and Tx for a pt with Stage C HF w/ reduced EF?
GOAL: control sxs, prevent hospitalization and mortality TX: ACE/ARB (ARNI), BB, Aldosertone antagonist (spironolactone), Diuretic some pts: Hydralazine/ISDN, Digoxin
What are the goals of therapy and Tx for a pt with Stage AD HF?
GOALS: control sxs, reduce hospital remission, establish EOL goals Temporary IV inotropic support using: - Adrenergic agonists (Dopamine, Dobutamine) - PDE Inhibitor (Milrinone) Transplant Palliative care LVAD
What are examples of AECI
Enalapril Lisinopril Captopril
What are examples of ARBs
Losartan Valsartan Candesartan
What is an ARNI compsed of?
Sacubitril/Valsartan
What loop diuretic can you use for CHF?
furosemide
what are BB you can use for CHF?
Bisoprolol Carvedilol Metoprolol succinate
What aldosterone antagonist can you use in CHF
spironolactone
