Pharmacology: heart failure Flashcards
What is heart failure?
What are the reflex/compensatory responses to heart failure?
When cardiac output doesn’t meet the demands of the body
In response, the heart uses reflex mechanisms to try and maintain/increase CO
○ Heart: increased HR and contractility
○ Vasculature: arterial/venous constriction
○ Adrenal: increased catecholamines
○ Kidney: increased renin (decreased renal perfusion) and increased angiotensin II. Angiotensin II can lead to cardiac growth and remodelling, medial/intimal thickening
Common symptoms of heart failure?
Dyspnoea
Fatigue
Decreased exercise tolerance
Less common symptoms of heart failure?
Nocturnal cough
Wheeze
Abdominal bloating
Anorexia
Confusion
Palpitations
Dizziness
Syncope
Bendopnoea (loss of breath when you bend over)
Common exam findings for heart failure?
Elevated JVP/hepatojugular reflex
Third heart sound
Laterally displaced apex beat
Less common exam findings for heart failure?
Weight gain (>2kg in a week)
Peripheral oedema
Pulmonary crackles
Is the prognosis for HF good or poor?
What are the goals of HF treatment?
Poor
Keep the patient alive and out of hospital
Symptom relief
Improve exercise tolerance
What are the 2 main types of heart failure?
HFpEF - heart failure with preserved ejection fraction (>50%)
HFrEF - heart failure with reduced ejection fraction (<50%)
HFpEF
- Who is it more common in (in terms of gender, age, comorbidities)
- Is it treated through lifestyle, diet, and exercise changes, and managing comorbidities?
- Are medications given in HFpEF? Why/why not
Women, older, multiple comorbidities
Yes
No - little evidence that they help, mainly gives ADRs
HFrEF
- Who is it more common in (in terms of gender, age, comorbidities)
- Is it often treated with drugs
Males, more evenly distributed across age, generally fewer comorbidities
Yes
