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Cardiovascular Medicine > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

What is heart failure?

A

Cardiac output is insufficient to meet the demands of the body

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2
Q

What are the causes of heart failure?

A

Pump failure
Excessive preload
Chronic excessive afterload

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3
Q

What causes pump failure?

A

Heart muscle disease

  • IHD
  • cardiomyopathy

Restricted filling

  • constrictive pericarditis
  • tamponade

Inadequate heart rate

  • heart block
  • post MI
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4
Q

What causes excessive preload?

A

Mitral regurg

Fluid overload

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5
Q

What causes chronic excessive afterload?

A

Aortic stenosis

Hypertension

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6
Q

What happens to the ejection fraction in systolic HF?

A

Reduced

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7
Q

What happens to the ejection fraction in diastolic HF?

A

Preserved

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8
Q

What happens to EDV in systolic HF?

A

Increased

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9
Q

What happens to EDV in diastolic HF?

A

Normal

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10
Q

Why does systolic HF occur?

A

Reduced contractility

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11
Q

Why does diastolic HF occur?

A

Low compliance

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12
Q

What causes systolic HF?

A

MI

Cardiomyopathy

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13
Q

What caused diastolic HF?

A

Hypertension

Aortic stenosis

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14
Q

What are the symptoms of left HF?

A 
Fatigue 
Dyspnoea
Nocturnal cough +/- pink frothy sputum
PND
Orthopnoea
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15
Q

What are the symptoms of right HF?

A

Peripheral oedema
Nausea
Raised JVP
Hepatomegaly (nutmeg liver)

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16
Q

What is nutmeg liver?

A

Appearance of liver as a result of hepatic venous congestion

17
Q

What are the signs of HF?

A 
Cold peripheries
Peripheral cyanosis
Narrow pulse pressure
Raised JVP
Displaced apex
Murmur 
Basal crackles - pulmonary oedema
18
Q

What is the NYHA HF classification

A

Class I - Heart disease present but no dyspnoea from ordinary activity

Class II - Comfortable at rest, dyspnoea on normal activities

Class III - less than ordinary activity causes dyspnoea

Class IV - dyspnoea present at rest

19
Q

What are investigations for suspected HF?

A

Bloods

  • FBS
  • U+Es
  • LFTs
  • Troponin
  • BNP

CXR

ECG

20
Q

What is BNP?

A

Brain natruiretic peptide

- produced in LV in response to stretch

21
Q

What are the effects of BNP?

A

Vasodilation
Diuresis
Naturesis

22
Q

What is high BNP?

A

Raised = 100-400
- Echo in 6 weeks

High = >400
- Echo in 2 weeks

23
Q

What are the CXR changes in HF?

A

Alveolar bat wings

Kerley B lines

Cardiomegaly

Dilated upper lobe vessels

Pleural effusion

24
Q

What is conservative HF management?

A

Stop smoking
Salt reduction
Weight loss

25
Q

What is the management of acute HF?

A

IV furosemide
B-blocker
ACEi

26
Q

What is the management of chronic HF?

A

ACEi
B-blocker
Hydralazine + nitrates
Spironolactone

Cardiovascular Medicine (13 decks)

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