CHF: Systolic Dysfunction Flashcards Preview

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Flashcards in CHF: Systolic Dysfunction Deck (25):
0

NYHA Classification

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

1

In CHF staging, can you move up and down?

just up

2

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

3

do BB prevent recurrent MI for patients with HF?

yes

4

what is BNP NOT meant to be?
what are BNP/NT-BNP affected by (x3)

a screening tool
age, renal function (inc.), obesity (dec.)

5

>? BNP in ED has a PPV of 90%?

500

6

100

7

is a CXR recommended for all HF patients?

yes

8

name two variables that are strong predictors of mortality/survival on a CPET (cardiopulm exercise test)

VO2
VE/VCO2

9

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)

10

in pt's with CHF< at what EF do you start an ACEI?

<40%

11

What did SOLVD trial show in HF?

enalapril lowers mortality and hospitalizations c/w placebo

12

3 BB that decrease mortality

carvedilol
metoprolol succinate
bisprolol

13

when would you start carvedilol for HF? Toprol XL?

carvedilol- high BP, DM/IGT
metoprolol succinate- marginal BP, causes less bronchospasm

14

RALES showed what?

mortality benefit with spirinolactone in pt's with Class III or IV HF already on ACE/BB.

15

RALES exclusion criteria

Cr>2.5
K>5

16

what did EMPHASIS trial show over the RALES trial?

mortality benefit with eplerenone even with Class II HF.

17

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?

A-HeFT

18

do diuretics dec. mortality?

no

19

causes of diuretic refractoriness

noncompliance
hypotension or renal artery stenosis or CRI
low CO

20

name a diuretic you can give if sulfa allergy

ethacrynic acid

21

what class of drugs are amiloride and triamterene?

potassium sparing diuretics

22

what level do you want dig to be?

<1 (.7-.9)

23

what is the major medication to adjust if you are on amiodarone?

warfarin!

24

do you give anabolic steroids to cachectic pt's?

no