[17] Heart Failure Flashcards

1
Q

What is heart failure?

A

When the heart cannot deliver adequate cardiac output to meet the metabolic needs of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What might the symptoms of heart failure be manifested by?

A

Symptoms of poor perfusion, and/or symptoms of congestion of circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What follows compromise of cardiac stroke volume in heart failure?

A

Cardiac decompensation and heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the underlying pathophysiological mechanisms that lead to compromise of cardiac stroke volume, cardiac decompensation, and heart failure?

A
  • Increased afterload (pressure work)
  • Increased preload (volume work)
  • Myocardial abnormalities
  • Tachycardias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is heart failure usually due to in neonates?

A

Obstructed systemic circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the causes of obstructed systemic circulation in neonates?

A
  • Hypoplastic left heart syndrome
  • Critical aortic valve stenosis
  • Severe coarction of the aorta
  • Interruption of the aortic arch
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is heart failure usually due to in infants?

A

High pulmonary blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What can cause high pulmonary blood flow in infants?

A
  • Ventricular septal defects
  • Atrioventricular septal defects
  • Large persistent ductus arteriosus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the causes of heart failure in older children and adolescents?

A
  • Eisenmenger syndrome
  • Rheumatic heart disease
  • Cardiomyopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the clinical features of heart failure?

A
  • Breathlessness, particularly on feeding and exertion
  • Sweating
  • Poor feeding
  • Recurrent chest infections
  • Poor weight gain or faltering growth
  • Tachypnoea
  • Tachycardia
  • Heart murmur/gallop rhythm
  • Enlarged heart
  • Hepatomegaly
  • Cool peripheries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What investigations should be done in heart failure?

A
  • CXR
  • Echo
  • ABG
  • ECG
  • Serum electrolytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What may be found on CXR in heart failure?

A

Cardiac enlargement and oligaemic lungs with pleural effusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What may be found on echo in heart failure?

A

Congenital heart defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What may be found on ABG in heart failure?

A

Reduced pO2 or metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why should ECG be done in heart failure?

A

May help determine aetiology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What may be found on serum electrolytes in heart failure?

A

Hyponatraemia due to water retention

17
Q

What is the definitive management for heart failure?

A

Management of the underlying cause

18
Q

What general measures are involved in the management of heart failure?

A
  • Bed rest, and nurse in semi-upright position
  • Supplemental oxygen
  • Diuretics
  • ACE inhibitors
  • Sufficient calorie intake