Week 4/7 Flashcards
What are the 3 typical symptoms of heart failure
breathlessness
* ankle swelling
* fatigue
What usually causes heart failure
Caused by a structural and/or functional cardiac abnormality, resulting in a
reduced cardiac output and/or elevated intracardiac pressures
What are the 3 main signs of heart failure
elevated jugular venous pressure
* pulmonary crackles
* peripheral oedema
Symptom burden is classified by what
The New York Heart Association (NYHA)
What is class 1 of NYHA
Comfortable at rest.
‘Mild’ heart failure
Annual mortality 10%
But ordinarily physical activity results in symptoms
What is class 3 of NYHA
Comfortable at rest
Patients have a marked limitation in physical activity
Moderate heart failure
Annual mortality 12-16%
What is incidence of heart failure
Due to ageing population, the overall incidence is ↑ * 5/1000 person-years in adults
What is the prevalence of heart failure
1-2% of all adults * ↑ with age:
* 1% in <55 years old
* >10% in ≥70 years old
What is class IV of NYHA
Patients have sdymptoms at rest
Severe heart failure
Annual mortality 15-20%
Worse prognosis than cancer
What are the main causes of heart failure
Coronary artery disease
Hypertension
Valve disease
These 3 are 70% of the causes of heart failure
Other:
Arrhythmia
Cardiomyopathy
Infective
Drug-induced
What is pathophysiology of heart failure
Ageing etc increase strain on heart muscle - heart muscle injury - decreases cardiac output - reduced renal perfusion and carotid barometer - increases sympathetic NS and RAAS - Increases heart rate 02 consumption and vasoconstriction - increasing pre and after load - causes hypertrophy etc - causes muscle injury
What is the ejection fraction
= (stroke volume/end-diastolic volume)*100
What are the 3 types of heart failure
HFpEF
HFmEF
HFyEF
What is Heart failure with preserved ejection fraction
On the rise * >50% of all HF
* Predominantly ♀
* Causes: Hypertension, diabetes, obesity, old age, restrictive
cardiomyopathies (Amyloidosis, HCM, Fabry’s) * Pathophysiology:
Impaired LV relaxation -> ↑LVEDP ->↓diastolic filling ->↓cardiac output * Treatment: Treat primary cause, diuretics, non specific.
What is HFmEF and HFrEF
Slowly decreasing * Main cause: ischaemic heart disease
(post-myocardial infarction) * Other causes of non-ischaemic cardiomyopathy
* Dilated cardiomyopathy * Alcohol induced cardiomyopathy * Nutritional * auto-immune * arrythmia induced
