Congestive Cardiac Failure Flashcards Preview

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Flashcards in Congestive Cardiac Failure Deck (23):
1

what is CCF?

Failure of the heart as a pump, so it cannot perfuse metabolic tissues

2

State the 3 main causes in order

1. IHD, 2. Cardiomyopathy and hypertension

3

What 6 other causes of CCF ?

1. Valvular heart disease e.g mitral regurgitation
2. Congenital heart disease
3. Constrictive pericarditis and cardiac tamponade
4. Alcohol and drugs e.g NSAIDs and B-Blockers
5. Circulation problems (anaemia, haemochromotosis, hypothyroidism)
6. Cor pulmonale and AF

4

What are the 3 main symptoms of CCF ?

1. Dyspnoea: exertional Dyspnoea, paramoxyl nocturnal dyspnoea and orthopnoea
2. Fatigue
3. Weight loss (due to cardiac cahexia)

5

What are the 3 main signs of heart failure ?

Raised JVP
Prominent 3rd heart sound and gallop rhythm if tachycardic
Bilateral basal crackles/crepitations

6

Mention the 2 symptoms of RVF

1. Nausea and anorexia
2. Swollen ankles

7

Mention the 3 signs of RVF

1. Hepatomegaly and ascites
2. Peripheral oedema
3. Raised JVP

8

What are the 2 symptoms of LVF ?

1. Dyspnoea: exertion related Dyspnoea, paramoxyl nocturnal dyspnoea and orthopnoea
2. Cough, productive of pink frothy sputum

9

What are the 3 signs of LVF ?

1. Cardiomegaly with displaced apex beat
2. Prominent 3rd heart sound and gallop rhythm if tachycardic
3.Bilateral basal crackles/crepitations

10

What are the first line diagnostic tools in CCF ?

ECG, CXR and BNP

11

What is the second line tool for CCF?

Echocardiography

12

What are the 3 things an ECG shows for CCF ?

1. Ischaemia, 2. Hypertrophy and 3. Arrhythmias

13

What are the 2 things a CXR shows for CCF ?

Cardiomegaly and pulmonary oedema (kerley B lines, prominent vasculature, pleural effusion, etc)

14

What does BNP mean ?

B-type or B-naturietic peptide

15

What happens to the level of BNP in CCF and what does this suggest ?

BNP levels are significantly raised in HF and is unlikely to be HF if it is not raised or low

16

When is an Echo used ?

When the first line investigations give abnormal results

17

State the 4 functions of an echo

1. Valvular insufficiency,
2. Cardiomyopathy, 3. Regional wall motion abnormalities, 4. Chamber dimensions

18

For treatment of CCF, using ACEIs answer the FF:
Example of this drug
ROA
MOA (3)
SE (4)

E.g ramipril
ROA: oral
MOA: 1. Inhibits RAAS and so oppose neurohormonal adaptation and prevents cardiac remodelling, 2. Reduces vasoconstriction and thus reduces preload and after load, 3. Reduces salt and water retention, thus reduces circulating volume
SE: Dry cough, post dose hypotension, hyperkalaemia and angioderma and renal impairment

19

For treatment of CCF, using Beta-Blockers answer the FF:
Example of this drug
ROA
MOA (3)
SE (3)

Example of this drug:
ROA
MOA: 1. reduce sympathetic activation, heart and oxygen consumption
2. Oppose neurohormonal adaptation and prevents cardiac remodelling
3. Will control arrhythmic activity in AG, so prevents sudden death
SE (3)

20

For treatment of CCF, using ATRA/ARB answer the FF:
Example of this drug
ROA
MOA
SE (2)

Losartan
ROA: oral
MOA: Similar to ACEI, angiotensin 2 receptor antagonist
SE: symptomatic hypotension and hyperkalaemia

21

For treatment of CCF, using aldosterone receptor anatagonist answer the FF:
Example of this drug
ROA
MOA (2)
SE (1)

Spinorolactone
ROA: oral
MOA: reduces the effects of aldosterone on the heart and I also is a K+ sparing diuretic.
SE: hyperkalaemia

22

For treatment of CCF, using digoxin answer the FF:
ROA (2)
MOA (2)
SE (3)

ROA: IM/IV
MOA: 1. Inhibits Na/K+ ATPase/pump, so increases cardiac contractility
2. Impairs AVN node conduction and increases vagal activity
SE: Diarrhoea, visual problems, nausea and anorexia

23

For treatment of CCF, using diuretics answer the FF:
Example of this drug for PO
ROA (2)
MOA (2) 😭
SE (3)

Furesomide
ROA: oral/IV
MOA (2): 1. Reduces circulating volume, thus pre-load and after load
2. Venodilation
SE (3): post-dose hypotension, gout and electrolyte disturbance (hypokalaemia etc