Flashcards in CHF: Systolic Dysfunction Deck (25):
I- cardiac dz without sxs
II- fatigue/palpitations/dyspnea w/ ordinary activity
IIIa- less than ordinary activity sxs
IIIb- minimal activity sxs
IV- rest pain
In CHF staging, can you move up and down?
Describe the CHF staging system
Stage A- high risk for HF. no actual HF.
Stage B- structural dz
Stage C- structural dz + sxs ever
Stage D- refractory HF needing special intervention
do BB prevent recurrent MI for patients with HF?
what is BNP NOT meant to be?
what are BNP/NT-BNP affected by (x3)
a screening tool
age, renal function (inc.), obesity (dec.)
>? BNP in ED has a PPV of 90%?
BNP in ED has NPV of 90%?
is a CXR recommended for all HF patients?
name two variables that are strong predictors of mortality/survival on a CPET (cardiopulm exercise test)
routine Bx in HF is not recommended. Name 3 cases where it is recommended.
rapidly progressive HF despite med Rx
suspect infiltrative process
malignant arrhythmias out of proportion to LV dysfxn (r/o giant cell myocarditis, sarcoid)
in pt's with CHF< at what EF do you start an ACEI?
What did SOLVD trial show in HF?
enalapril lowers mortality and hospitalizations c/w placebo
3 BB that decrease mortality
when would you start carvedilol for HF? Toprol XL?
carvedilol- high BP, DM/IGT
metoprolol succinate- marginal BP, causes less bronchospasm
RALES showed what?
mortality benefit with spirinolactone in pt's with Class III or IV HF already on ACE/BB.
RALES exclusion criteria
what did EMPHASIS trial show over the RALES trial?
mortality benefit with eplerenone even with Class II HF.
which trial showed that you can consider hydrazine/isordil in any pt (not just AA's) w/ HF Class II or greater b/c of survival benefit?
do diuretics dec. mortality?
causes of diuretic refractoriness
hypotension or renal artery stenosis or CRI
name a diuretic you can give if sulfa allergy
what class of drugs are amiloride and triamterene?
potassium sparing diuretics
what level do you want dig to be?
what is the major medication to adjust if you are on amiodarone?