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Jamie Cardiovascular Pathology > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

What is heart failure?

A

A clinical syndrome comprising of dyspnoea, fatigue or fluid retention due to cardiac dysfunction

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2
Q

What are 4 clinical risk factors of chronic heart failure?

A

Hypertension
Diabetes
Obesity
Coronary heart disease

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3
Q

What are 3 symptoms of heart failure?

A

Breathlessness
Fatigue
Oedema

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4
Q

What are 4 signs on examination of heart failure?

A 
Tachycardia
Raised JVP
Chest crepitations/effusions
3rd heart sound
Displaced/abnormal apex beat
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5
Q

What are 2 screening tests that can be performed for heart failure?

A

ECG

BNP (brain natriuretic peptide) measurement

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6
Q

How does BNP react in heart failure?

A

BNP is elevated

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7
Q

What condition of heart failure is unlikely with a normal ECG?

A

Left ventricular systolic dysfunction

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8
Q

What investigation should be performed when an elevated BNP is identified?

A

ECHO

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9
Q

What do structural cardiac abnormalities usually lead to?

A

Heart Failure

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10
Q

What are the 4 primary causes of LVSD?

A

Ischaemic heart disease
Aortic valve disease
Mitral regurgitation
Dilated cardiomyopathy (all secondary causes not related to IHD or valves)

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11
Q

How can disease affect the LV ejection fraction?

A

Can either increase or decrease it

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12
Q

What investigation can be used to determine LV ejection fraction?

A

ECHO

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13
Q

What percentage is a severe LV ejection fraction?

A
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14
Q

What scan other than ECHO can be used to identify LV ejection fraction?

A

MUGA scan

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15
Q

What is it is involved in systolic heart failure?

A

Decreased pumping function resulting in fluid back up in lungs and heart failure?

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16
Q

What is it is involved in diastolic heart failure?

A

The heart muscle thickens and becomes stiff causing the heart not to fill with blood properly resulting in fluid backup of the lungs and heart failure

17
Q

What are the 2 (salt and waters retaining and vasoconstriction) systems involved in the neuroendocrine response to heart failure?

A

The renin-angiotensin-aldosterone system

The sympathetic system

18
Q

What are the 2 (salt and waters excretion and vasodilation) systems involved in the neuroendocrine response to heart failure?

A

Natriuretic peptide system

ERDF

19
Q

What are the 3 drugs that are used to improve the symptoms of heart failure?

A

Diuretics
Digoxin
ACE inhibitors/ARBs

20
Q

What are the 4 drugs that are used to improve the survival of heart failure?

A

ACE inhibitors/ARBs
B Blockers
Ivabradine
Spironolactone`

21
Q

What are the 3 aims of symptomatic treatment of heart failure?

A

Inhibition of detrimental neurohormonal adaptions
Enhancement of beneficial neurohormonal adaptions
Enchancement of cardiac function

22
Q

What is the main drug type for symptomatic treatment of heart failure?

A

Loop diuretics

23
Q

What is the main drug used for loop diuretics?

A

Furosemide

24
Q

What are 4 adverse drug reactions of loop diuretics?

A

Dehydration
Hypotension
Hypokalaemia
Gout

25
Q

What drugs should furosemide not be used with? (5)

A 
Aminoglycosides
Lithium
NSAIDs
Antihypertensives
Vancomycin
26
Q

What is spironolactone an example of?

A

An aldosterone antagonist

27
Q

What should spironolactone be used with to reduce mortality of heart failure patients?

A

ACEI

28
Q

When should B blockers be used in heart failure?

A

Once a patient has been stabilised not during acute presentation (and only by specialists)

29
Q

What are 2 examples of B blockers

A

Carvedilol
Bisoprolol
Metoprolol

30
Q

What is the typical therapeutic regime (in order) for treating heart failure?

A

Furosemide (loop diuretic)
ACEI
B blocker
(Digoxin or Warfarin in special cases)

Jamie Cardiovascular Pathology (17 decks)

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