Heart Failure Flashcards

1
Q

what is heart failure?

A

the state in which the heart is unable to pump blood at a rate commensurate with the requirements of the tissues or can only do so at high pressures

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2
Q

describe impairment of left ventricular filling

A

in diastole, the left ventricle walls relax allowing for filling of the cavity
without proper LV relaxation, the volume of blood filling the cavity is reduced thus reducing the stroke volume, the volume of blood ejected with each contraction

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3
Q

describe impairment of ejection of blood

A

due to LV wall damage, the LV may have reduced ability to pump or eject blood

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4
Q

what are the causes of HF?

A
coronary heart disease
hypertension
diabetes
dilated cardiomyopathy 
valve disease
tachycardic arrhythmias
HEFpEF
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5
Q

what are the usual symptoms of HF?

A
SoB
difficulty breathing at night 
reduced exercise tolerance 
fatigue
tiredness 
ankle swelling
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6
Q

what can an ECG find in HF?

A

arrythmias
past MI
LVH

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7
Q

what can a chest x ray find in HF?

A

size and shape of the cardiac silhouette

evidence of fluid accumulation in the lungs

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8
Q

what is HFrEF?

A

heart failure with an EF <40%

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9
Q

what is HFpEF?

A

heart failure with a normal EF (>50%)

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10
Q

what is ANP?

A

an atrial hormone

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11
Q

what is BNP?

A

a ventricular hormone

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12
Q

what does a high BNP indicate?

A

heart failure so patients are referred for an echo

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13
Q

what drugs are used to prolong survival?

A
ACEi
B blockers
spironolactone
vasodilators
ivabradine
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14
Q

what drugs are used to improve symptoms?

A

digoxin

frusemide

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15
Q

what is cardiac resynchronisation therapy?

A

pacing the LV from the left lateral wall

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16
Q

which patients receive CRT?

A

those who have LBBB in HF

17
Q

how do you treat end stage HF?

A

control fluid retention
iv inotropics/ vasodilators
consider resynchronisation, mechanical assist devices and heart transplantation

18
Q

what are the indications for heart transplant?

A

refractory cardiogenic shock
documented dependance on IV inotropic support
severe symptoms of ischaemia
recurrent symptomatic ventricular arrhythmias