Lecture 7 heart failure and hypertension Flashcards
What is heart failure?
the heart is unable to pump sufficient blood to meet the demands of the body
What are the risk factors for CHF
- CAD
- HTN
- MI
- Smoking
- Diabetes
- obesity
- Heart valve disease
- cardiomyopathy
What is left-sided heart failure?
- Most common type of HF
- left ventricle does’nt pump properly
- blood does not reach the body effectively
- back up of blood in the pulmonary system
What is right sided heart failure?
- right side cant pump blood properly
- usually caused by LSHF / lung pathology
Explain systolic heart failure?
- cardiac muscle is weakened
- less blood pumped out of the ventricles
Explain diastolic heart failure?
- stiff myocardium cant relax normally
- ventricles are unable to fully relax
How is HF measured
New york classification scale
I-IV
How does an ECG suggest HF?
QRS dispersion
QT dispersion along V1-V6
How does a CxR indicate HF?
cardiomegaly
fluid in the lungs
What bloods indicate HF?
presence of BNP ( released from ventricular muscle )
How can an Echo distinguish between types of HF?
systolic is distinguished from diastolic by measuring ejection fraction
What is ejection fraction
Amount of blood pumped by ventricle / amount of blood in the ventricles
What does a reduced ejection fraction show?
-systolic heart failure
What does a perserved ejection fraction show?
- diastolic heart failure
- normal contraction but filling is impaired
Symptoms of left-sided HF?
- dyspnoea
- SOB
- orthnopea
- fatigue
- wheeze / chronic cough
Symptoms of right-sided HF?
- SOB
- raised JVP
- pitting oedema
- ascites
- hepatomegaly
What is HTN a risk factor for?
- stroke
- MI
- CKD
- HF
- Cognitive decline
What is essential HTN?
- idiopathic
- linked to genetic/ obesity / diet/ lack of excercise
- 95% of HTN cases
What is secondary HTN?
Underlying primary cause:
- endocrine disease
- kidney disease
- tumours
- 5% of HTN cases
What is stage 1 HTN
BP > 140/90 Hgmm
What is stage 2 HTN
BP > 160/100
What is stage 3 HTN
clinic BP > 180
What are the three key population priorities for HTN?
- Diagnosis.
- Initiating and monitoring antihypertensive drug treatment.
- Choosing antihypertensive drug treatment
How is the diagnosis of HTN confirmed?
Ambulatory blood pressure monitoring
Home blood pressure monitoring