chronic heart failure Flashcards
1
Q
why does CHF happen
A
impaired L ventricular contraction
or
impaired L ventricular relaxation
2
Q
presentation
A
SOB - worse onn exertion cough - frothy sputum orthopnoea paroxysmal nocturnal dyspnoea peripheral oedema
3
Q
paroxysmal nocturnal dyspnoea
A
sudden waking at night with severe attack of SOB and cough
4
Q
mechanism of PND
A
- fluid settles across large surface area of lungs whilst sleepig lying flat
- respiratory centre in brain less responsive in sleep
- less circulating adrenalin during sleep - worsens caridac outpt
5
Q
diagnosing CHF
A
clinical presentation
BNP
ECHO
ECG
6
Q
causes of CHF
A
IHD
valvular heart disease - aortic stenosis
hypertension
arrythmias - AF
7
Q
Mx
A
specialist referral
medical Mx
surgical Mx if aortic stenosis/mitral regurg
8
Q
additional Mx
A
flu + pneumococcal vaccine
stop smoking
exercixw
9
Q
1st line medical treatmetn
A
ACEI
Beta blocker
loop diuretic e.g. furosemide
10
Q
when to use aldosterone antagonist
A
when there is reduced ejection fraction and uncontrolled symptoms with ACEI and beta blocker
