CV HF

Question 1

HEART FAILURE SYMPTOMS?

SPARF

Answer 1

SOB
Persistent cough/wheezing
Ankle swelling - heart cant pump fluid efficiently
Reduced exercise tolerance
Fatigue

Question 2

2 types of HF

Answer 2

preserved EF
reduced EF

Question 3

CHRONIC HEART FAILURE

1st LINE?

Answer 3

1. ACEi + BB
   Start at low dose+titrate up slowly to max.
   ARB instead if ACE-I not tolerated (licensed only- candesartan/losartan/valsartan)

1a. Hydralazine+nitrate if both ACEi & ARB not tolerated (common in African/Caribbean origin)

2. SPIRO AFTER HYDRALAZINE+NITRATE!. AC

Question 4

CHRONIC HEART FAILURE

SYMPTOMS PERSIST?

Answer 4

SYMPTOMS PERSIST?
Add aldosterone antagonist- spironolactone/eplerenone

SYMPTOMS PERSIST 2?
Add amiodarone/digoxin/sacubitril w/ valsartan/ivabradine/dapagliflozin

Dapagliflozin has water loss side-effect, chronic HF excess fluid
Digoxin for patients in sinus rhythm in worsening/severe HF

Question 5

CHRONIC HEART FAILURE

LOOP DIURETICS PURPOSE?

Answer 5

Relieve breathlessness/oedema in fluid retention,

furosemide/bumetanide/torasemide

Question 6

CHRONIC HEART FAILURE

DIGOXIN HF LOADING DOSE?

Answer 6

62.5-125mcg OD

Question 7

check guidelines for more info and notes
https://bnf.nice.org.uk/treatment-summaries/chronic-heart-failure/