HYHO HF Flashcards
What is the definition of HF?
- 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
Stages of HF
(sorry the pic was blurry)
What is the dx of HF based on?
thorough hx and PE
What are the categories of HF?
- 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
NYHA Functional Classes of HF
When do you hear the following:
- AS
- MR
- AR
- MS
- VSD
Signs and Sx of HF (flow chart)
WHen looking at a CXR of a HF pt, what are you looking for?
What is the grading scale of edema?
What are the major criteria of the Framingham criteria of HF?
- 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
What are the minor criteria of the Framingham criteria of HF?
- 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
If a pt. presents with acute onset and progressed rapidly over a few minutes, what is your ddx?
If pt presents with gradually onset and progressed rapidly over hours to days, what is your ddx?
If a pt presents with gradually onset and progressed relentlessly over wks/months, what if your ddx?
If a pt presents with gradually onset of sx and progressed relentlessly over months/yrs?
HF dx by the specialist (flow chart)
What parasympathetics are associated with HF? tenderpoints?
- 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
What sympathetics are involved in HF? tenderpoints?
- T1-5
- increased tone –> tachycardia
- TPs: tissue texture changes over TPs, rotated vertebrae
What motor elements are involved in HF? tender points?
- C3-5 (phrenic n.)
- irritation due to lung proximity
- TPs: tissue texture changes over cervical pillars, rotated vertebrae
What are some common SDs seen in HF?
- Dependent extremity edema
- Rib dysfunction
- Flattened diaphragm
- Scalene hypertonicity and tender points
- Pectoralis minor hypertonicity and tender points
What are some 2 minute treatments for HF? 5 minute? Extended Tx?
- LE - pedal pump
- Rib raising
- Extended
- Head -
- OA relase or V spread (OA)
- decreased CRI - CV4 hold
- Abdomen - diaphragm
- Doming technique
- Thoracolumbar junction - ME, MFR, HVLA
- Rib dysfunction - ME
- Cervical - C2, C3-C5 (MFR, ME, FPR)
- LE/UE - effleurage
- Cervical - scalenes (CS, ME)
- UE - pectoralis minor (CS, MFR)
- Abdomen/other/viscerosomatic - chapman’s reflex for heart
- Head -
What are signs/sx of Acute decompensated HF?
What are diagnostic studies for acute decompensated HF?
What are txs for acute decompensated HF?
sorry didn’t feel like typing it up
What are the most common tx modalities for HFpEF?
- tx should target associated conditions (ex. HTN)
- Unlike HFrEF, beta blockers, ACE inhibitors, ARBs, and cardiac resynchronization are not effective in HFpEF
What are the most common tx modalities for HFrEF?
- management of contributing factors and associated conditions, lifestyle modification, pharmacologic therapy, device therapy if indicated, cardiac rehabilitation, and preventive care
