Heart Failure Flashcards
How does heart failure most commonly arise?
When cardiac output is low (many causes), body thinks fluid is low and so retains fluid, causing fluid overload, thus the heart has to work harder (and often can’t)
What are the main causes of left sided heart failure?
Ischaemic heart disease (MI etc.)
Cardiomyopathies
Valvular disease
How do numerous MIs lead to heart failure?
Scar tissue is left resulting in reduced contractility, so cardiac output decreases
What are the main causes of right sided heart failure?
Secondary to left heart failure
Cor pulmonale
Congenital defects
How does cor pulmonale cause heart failure?
Lung disease causes hypoxia, resulting in pulmonary vasoconstriction, causing increased back pressure, so right heart has to work harder and often fails
What are the main symptoms of left heart failure?
Dyspnoea on exertion/rest
Orthopnoea
PND
Pink, frothy sputum (pulmonary oedema)
What are the main signs of left heart failure?`
Tachycardia Crepitations Pleural effusion S3 Cardiomegaly, bats wings on CXR
What are the main symptoms and signs of right heart failure?
Ankle swelling
Raised JVP
Hepatomegaly
Ascites
What are the main drugs used for heart failure?
Loop diuretics ACEi B blockers Spironolactone Digoxin
What invasive therapy can be used to treat heart failure?
Implantable defibrilators
Cardiac resynch therapy
What does cardiac resynch therapy achieve?
If both sides of heart contracting at different times (slight delay), CRT minimises this gap to improve cardiac efficiency
What is the unwanted effect of furosemide?
Hypokalaemia
How might hypokalaemia be corrected in heart failure treatment?
Use furosemide in conj with ACEi/spironolactone - these cause hyperkalaemia
What type of drug is spironolactone?
Aldosterone antagonist
How does left ventricular failure cause pulmonary oedema?
LV failure cause LA pressure to rise, causing back pressure on the lungs which increases pulmonary capillary hydrostatic pressure, causing fluid to accumulate in the pleural space
