Session 9 - Heart Failure Flashcards
Define heart failure
a state in which the heart fails to maintain an adequate circulation for the needs of the body despite an adequate filling pressure
What is the primary cause of systolic heart failure?
IHD
Give some causes of HF other than IHD
o Hypertension o Cardiomyopathies Alcohol/Drugs/Poisoning Iron overload Pregnancy o Valvular heart disease / Congenital o Restrictive cardiomyopathy e.g. amyloidosis o Hypertrophic cardiomyopathy o Pericardial disease o Arrhythmia
What is prognosis after MI related to?
Prognosis after MI (or any cardiac injury) is inversely related to the amount of left ventricular damage/dysfunction.
What are the four ways in which heart failure is managed?
o Correct underlying cause o Non-pharmacological measures o Pharmacological therapy Symptomatic improvement Delay progression of heart failure Reduce mortality o Treat complications/associated conditions/CVS risk factors E.g. arrhythmias
How can you improve HF prognosis?
o RAAS Antagonism
ACE inhibitor – E.g. Ramipril
Angiotensin Receptor Blocker – E.g. Losartan
Aldosterone blockade – E.g. Spironolactone
o Beta-Blocker
E.g. Propranolol, Atenolol
Give five drugs used to treat HF
o -blockers
Block 1 receptors on the myocardium
o ACE-Inhibitors
Prevent conversion of Angiotensin I II
o Ca2+ channel blockers
Reduce contractility of the myocardium
o Organic Nitrates
Venodilator – Reduce preload on heart, lowering its O2 requirement
Vasodilator – Coronary arteries dilate, supplying more O2.
o Cardiac Glycosides
Increase CO and heart contractility by inhibiting the Na/K pump. Raising intracellular Na inhibits NCX, so intracellular Ca2+ increases in. contractility