Session 10- Management and Treatment of Heart Failure Flashcards
Class 1 heart failure
No symptomatic limitation of physical activity
Class 2 heart failure
- slight limitations of physical activity
- ordinary physical activity results results in symptoms
- no symptoms at rest
Class 3 heart failure
– Marked limitation of physical activity – Less than ordinary physical activity results in symptoms – No symptoms at rest
Class 4 heart failure
– Inability to carry out any physical activity without symptoms – May have symptoms at rest – Discomfort increases with any degree of physical activity
Key questions to ask in heart failure
Does the person have heart failure?
-history
Differential diagnosis
What sort of heart failure does the patient have?
What is causing heart failure
Management of heart failure- symptomatic
Symptomatic treatment
-furosemide
Management of heart failure prognostic treatment in left ventricular systolic dysfunction
Cardiac rehabilitation
ACE/ARB
Beta blocker
MRA
Sacubitril
Biventricular pacemaker
What to do when you see heart failure
Emergency
ABCDE
Immediate treatment
- furosemide
- o2
- resp support
- nitrates and morphine
Blood tests in heart failure
FBC U&Es LFTs Clotting Thyroid function, vit B level CRP- inflammation
How does atrial fib affect BNP/NTpro-BNP
- hormone released in response to atrial/ventricular stretch due to fluid overload
- AFib can triple BNP
Further investigation sof heart failure
Trans thoracic echocardiogram
Stress cardiac MRI scan/ coronary angiogram
Prognostic treatment
- ACE/ARB
- Beta blockerrs
- mineralcortocid receptor antagonist
- bi ventricular ICD
Physiological effects of beta blockers
1) reduce heart rate - cardiac beta receptor
2) reduce BP
3) reduce mobilisation. Of glycogen
4) negative unwanted effect of catecholamins
