Heart failure Flashcards
- Discuss the epidemiology of heart failure.
Prevelnce and incidence increases with age. around 60000 patients have it in Scotland
- Know the prognosis of heart failure.
survival rate greater than lung, pancreas and oesophagus cancer but lower than prostate, colon and breast cancer
symptoms of heart failure
breathlessness, fatigue, oedema, reduced excerise capacity
signs of heart failure
odema, tachycardia, raised JVP, chest crepitations or effusion, 3rd heart sound and displaced or abnormal apex beat
Potential screening tests for heart failure
12 lead ECG
BNP (brain B-type) natriuretic peptide can be measured in blood and elevated in heart failure
Causes of LV systolic dysfunction
ischaemic heart disease
inherited
toxins e.g alcohol
hypertension
aortic valve disease or mitral regurgitation
LV ejection fraction
stroke volume/end diastolic volume
disease and pathological changes can both decrease and increase LVEF
why can LVEF be difficult to quantify on US
due to quality of images, experience of operator, use of contrast agents, time consuming to perform
what is biplane modified Simpsons rule
divides LV cavity into multiple slices of known thickness and diameter
thinner slices make is easier to estimate volume
endocardial border is sometimes hard to trace
MUGA scan
easy to obtain accurate figure for the LVEF
greater reproducibility
ionising radiation can be high
gives no additional structural info
cardiac MRI
more accurate than US
EXPENSIVE, TIME CONSUMING
can’t be done at bedside
requires breath holding and claustrophobia is an issue
how do you grade heart failure
on the severity of symptoms
does heart failure reduce cardiac output
no
pharmacological treatment of heart failure
ACE inhibitors
beta blockers
aldosterone receptor blocker
angiotensin receptor inhibitor
