Case study HF Flashcards

1
Q

What is Ejaction Fraction

A

Stroke volume/ End diastolic volume

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2
Q

What has a better prognosis preserved or reduced RF ?

A

Preserved

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3
Q

How do you diagnose HF

A

ECG - Patients can develop arythmias !!

Natriuretic peptides - NT-proBNP

Echo - Preserved or reduced EF ?

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4
Q

If you have a normal ECG can you have heart failure

A

Extremely unlikely

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5
Q

What is BP

A

HR X SV

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6
Q

What is BP

A

CO X SVR

(resistance)

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7
Q

If NT- Pro- BNP > 2000ng/L what do you do ?

A

Specialist review
Echo within 2 weeks

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8
Q

If NT- Pro- BNP 40-2000ng/L what do you do ?

A

Echo within 6 weeks

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9
Q

If NT- Pro- BNP < 400ng/L what do you do ?

A

Heart failure is unlikely

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10
Q

Other than HF, when else might you have increase Natriuretic peptides ?

A

HF
ACS
LVH
VALVE DISEASE
CARDIOVERSION MYOCARDITIS
TACHY ARYTHMIAS

ELDERLY
STROKE
SAH
CKD
CIRRHOSIS
COPD
INFECTION
SEPSIS

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11
Q

When is BNP reduced?

A

Obesity
ACE INHIBTORS
BETA BLOCKERS
AFRO CARRIBEANS

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12
Q

When is BNP released ?

A

Myocardial stress

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13
Q

What are kerley b lines

A

Kerley B lines (arrows) are horizontal lines in the lung periphery that extend to the pleural surface. They denote thickened, edematous interlobular septa often due to pulmonary edema.

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14
Q

Pharmacological interventions for HF

A

1 - Loop Diuretics

2 - Beta-blockers - reconstruction of the heart - Help reduce mortality
3- ACE inhibitors
4 - Aldosterone receptor antagonist
5 - SGLT2 inhibitor

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15
Q

Would you give the ACE inhibitor and Beta-blocker with severe aortic stenosis?

A

No - after her valve has been sorted

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16
Q

Spirlactolone can cause breast enlargement, what is the name for this?

A

gynecomastia

17
Q

Remember to check Iron with reduced ejection fraction - why

A

Can improve symptoms

18
Q

Non Pharmacological interventions for HF

A

Low sodium diet - HOWEVER DO NOT TAKE LOW SODIUM LABELLED FOOD.

Smoking

Drinking

Cardiac rehabilitation for stable HF

Fluid restriction

Ask the patient to do daily weights

Nutrition - malnutrition

Saftey nets

19
Q

How often would you see an HF patient in GP?

A

6 month MINIMUM