Heart Failure Flashcards

1
Q

Name two types of Heart Failure

A
HFrEF= Heart failure reduced ejection fraction
HFpEF= heart failure with preserved ejection fraction
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2
Q

Describe HFrEF

A

Systolic dysfunction
Reduced capacity to pump blood out of the ventricles,
Fluid backs up into lungs

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3
Q

Describe HFpEF

A

Diastolic Dysfunction
Heart doesn’t stretch properly so reduced filling
Fluid backs up into lungs

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4
Q

Which renal system is activated?

A

RAAS
less blood leaving the heart so thinks that the body has low blood volume- leads to increases retention of water and sodium.

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5
Q

Symptoms of Heart Failure

A

Shortness of Breath- fluid in lungs
Fatigue
Oedema- fluid retention

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6
Q

Signs of Heart Failure

A
  • Elevated JVP
  • Oedema
  • Tacycardia
  • Dyspnoea
  • 3rd Heart sounds
  • abnormal apex beat
  • cardiomegaly
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7
Q

Risk factors for Heart failure

A

Valve disease
coronary artery disease
HTN
MI

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8
Q

Diagnosis of HF

A
Signs and symptoms of heart failure 
PLUS
Evidence of cardiac dysfunction
PLUS 
response to diuretics (if still in doubt)
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9
Q

Investigations

A

ECHO
MUGA/ RNVG - ejection fraction
Cardiac MRI
Left ventriculography

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10
Q

Why measure the ejection fraction?

A
Can show severity
50% plus is normal
40-50% mild HF
30-40% moderate HF
<30% severe HF
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11
Q

Screening>

A

ECHO- normal = not HF

ANP/BNP= elevated in HF

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12
Q

Treatment of HF

A
Loop diuretics- furosemide
Thiazide type diuretics (if resistant)
ACE inhibitors- ramapril 
ARBs- valsartan, losartan
Beta blocker- carvedilol, bisoprolol 
Spironolactone + loop diuretic
Ivabridine - slows HR
Warfarin- prevention of CVA.
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13
Q

Two aims of HF treatment

A

Improve symptoms

Improve Survival

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14
Q

What is ARNI?

A

Valsartan + Neprilysin
Block AT1 receptors
Stop breakdown of ANP & BNP

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15
Q

What else is important for treatment?

A

Monitor weight and increase meds according to weight and symptoms

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16
Q

NSAIDS?

A

can cause renal failure if given with ACEI.