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PCM III > HYHO HF > Flashcards

HYHO HF Flashcards

1
Q

What is the definition of HF?

A
  • a complex clinical syndrome that results from structural or functional impairment of ventricular filling or ejection of blood
  • leads to dyspnea, fatigue, edema and rales
  • many patients present without signs or symptoms
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2
Q

Stages of HF

A

(sorry the pic was blurry)

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3
Q

What is the dx of HF based on?

A

thorough hx and PE

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4
Q

What are the categories of HF?

A
  • HFrEF - LV EF of 40% or less (CAD is main cause; leads to LV dilation)
  • HFpEF - LVEF of 50% or more (HTN is main cause; leads to LV hypertrophy)
  • Patients with values of 41% to 49% are classified as having borderline reduced ejection fraction
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5
Q

NYHA Functional Classes of HF

A
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6
Q

When do you hear the following:

  • AS
  • MR
  • AR
  • MS
  • VSD
A
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7
Q

Signs and Sx of HF (flow chart)

A
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8
Q

WHen looking at a CXR of a HF pt, what are you looking for?

A
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9
Q

What is the grading scale of edema?

A
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10
Q

What are the major criteria of the Framingham criteria of HF?

A
  • PND
  • Orthopnea
  • Elevated JVP
  • Crepitations
  • S3
  • Radiological evidence of cardiomegaly
  • Radiological evidence of PE

*dx of HF requires the presence of 2 major criteria or 1 major and 2 minor criteria

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11
Q

What are the minor criteria of the Framingham criteria of HF?

A
  • extremity edema
  • nigh cough
  • exertional dyspnea
  • hepatomegaly
  • PE
  • HR >120
  • loss of >4.5 kg in 5 days following diuretic tx

*dx of HF requires the presence of 2 major criteria or 1 major and 2 minor criteria

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12
Q

If a pt. presents with acute onset and progressed rapidly over a few minutes, what is your ddx?

A
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13
Q

If pt presents with gradually onset and progressed rapidly over hours to days, what is your ddx?

A
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14
Q

If a pt presents with gradually onset and progressed relentlessly over wks/months, what if your ddx?

A
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15
Q

If a pt presents with gradually onset of sx and progressed relentlessly over months/yrs?

A
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16
Q

HF dx by the specialist (flow chart)

A
17
Q

What parasympathetics are associated with HF? tenderpoints?

A
  • vagus n., OA, AA, C2
    • increased tone –> bradycardia
  • TPs: tissue texture changes over cervical pillars, rotated vertebrae, compression of occipitomastoid sutures as well as occipito-atlantoid joint
18
Q

What sympathetics are involved in HF? tenderpoints?

A
  • T1-5
    • increased tone –> tachycardia
  • TPs: tissue texture changes over TPs, rotated vertebrae
19
Q

What motor elements are involved in HF? tender points?

A
  • C3-5 (phrenic n.)
    • irritation due to lung proximity
  • TPs: tissue texture changes over cervical pillars, rotated vertebrae
20
Q

What are some common SDs seen in HF?

A
  • Dependent extremity edema
  • Rib dysfunction
  • Flattened diaphragm
  • Scalene hypertonicity and tender points
  • Pectoralis minor hypertonicity and tender points
21
Q

What are some 2 minute treatments for HF? 5 minute? Extended Tx?

A
  1. LE - pedal pump
  2. Rib raising
  3. Extended
    1. Head -
      1. OA relase or V spread (OA)
      2. decreased CRI - CV4 hold
    2. Abdomen - diaphragm
    3. Doming technique
    4. Thoracolumbar junction - ME, MFR, HVLA
    5. Rib dysfunction - ME
    6. Cervical - C2, C3-C5 (MFR, ME, FPR)
    7. LE/UE - effleurage
    8. Cervical - scalenes (CS, ME)
    9. UE - pectoralis minor (CS, MFR)
    10. Abdomen/other/viscerosomatic - chapman’s reflex for heart
22
Q

What are signs/sx of Acute decompensated HF?

A
23
Q

What are diagnostic studies for acute decompensated HF?

A
24
Q

What are txs for acute decompensated HF?

A

sorry didn’t feel like typing it up

25
Q

What are the most common tx modalities for HFpEF?

A
  • tx should target associated conditions (ex. HTN)
  • Unlike HFrEF, beta blockers, ACE inhibitors, ARBs, and cardiac resynchronization are not effective in HFpEF
26
Q

What are the most common tx modalities for HFrEF?

A
  • management of contributing factors and associated conditions, lifestyle modification, pharmacologic therapy, device therapy if indicated, cardiac rehabilitation, and preventive care

PCM III (26 decks)

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