Cardiovascular Flashcards
(12 cards)
What is the first-line treatment for all patients with Chronic heart failure?
Both an ACE inhibitor and Beta-Blocker.
- One drug should be started at a time.
What is the second line therapy for Chronic heart failure?
Aldosterone antagonist (Spironolactone)
N.B. ACEi and Aldosterone antagonists cause Hyperkalaemia so Potassium has to be monitored.
SGLT-1 Inhibitors also have a role in management of HF with reduced Ejection fraction.
What vaccinations should patients with chronic heart failure have?
Annual Influenza vaccine and One off Pneumococcal Vaccine.
In which valvular disorder would Nail bed pulsation (quincke’s sign) be seen?
Aortic Regurgitation typically. (Early diastolic murmur)
Also causes a wide pulse pressure.
What finding on a ECG may be seen with Hypothermia?
Osborn (J) waves
What is the first-line investigation for a patient with suspected Chronic Heart failure?
Pro-BNP blood test
If NTproBNP levels are “HIGH” (>2000pg/ml) in chronic HF, what should be done next?
Specialist assessment (including transthoracic echocardiography) within 2 weeks
If NTproBNP levels are “RAISED” (400-2000pg/ml) in chronic HF, what should be done next?
Specialist assessment (including transthoracic echocardiography) within 6 weeks
When should patients with Aortic Stenosis be referred for consideration of an Aortic Valve Replacement (AVR)?
- When there is LVEF less than 55%.
- When there is a valvular gradient >40mmHg and signs of LV Systolic Dysfunction.
- If the patient is symptomatic.
What are the different management options available to someone with Aortic Stenosis?
- Aortic Valve Replacement (for patients who are not high operative risk)
- Transcatheter AVR (TAVR) (used for patients who are high operative risk)
What type of murmur is typical with aortic stenosis?
Ejection systolic
What is the most appropriate diagnostic investigation for a patient with worsening breathlessness and signs of Heart Failure?
Echocardiography
