Heart Failure Flashcards Preview

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Flashcards in Heart Failure Deck (20):
1

Main causes of left heart failure

IHD
Cardiomyopathy
Valvular disease

2

Main causes of right heart failure

2ndry to left heart failure
Cor pulmonale
Congenital heart disease

3

LVF signs

Tachycardia
Fine crepitations
Pleural effusion
S3
(Gallop rhythm = S3 + tachycardia)

4

Bats wing shadows (esp lower zones)

LVF

5

CXR signs of LVF?

Cardiomegaly
Bats wings shadows (esp lower zones)
Interstitial fluid

6

Right heart failure signs?

Oedema (ankle/sacral)
JVP elevated
Hepatomegaly
Ascites

-CXR normal

7

Treatment for Cor Pulmonale / CCF

Diuretics and digoxin only

8

Treatment for CCF caused by vavlular disease?

Surgery ideally

9

Treatment for heart failure caused by AF?

Digoxin or DC shock

10

Standard treatment for CCF?

Diuretics to excrete retained fluid
Angiotensin converting enzyme inhibitors
Beta Blockers (caution required)
Spironolactone (severe cases only)

Digoxin (used as an add on if already on beta blockers and ACEi)
Other vasodilators (nitrates, hydralazine)

Implantable cardiac defibrillators
Cardiac resynchronisation therapy
Transplantation

11

Therapy for acute LVF

1) Sit up
2) Oxygen
3) IV frusemide
4) IV diamorphine (not in COPD)

12

Blood tests

FBC
Liver biochem
Urea and electrolytes
Cardiac enzymes in acute heart failure (will be raised, released in response to stretch)

13

CXR

Cardiomegaly
Bats wings
Effusion
Kerley B lines
Pulmonary oedema

(normal in right heart failure)

14

ECG

Look for ischaemia, hypertension or arrhythmia

15

Beta blockers in heart failure, what should you watch out for?

Caution in obstructive airway disease, bradyarrhythmias
Avoid in acute heart failure until cardiovascularly stable

16

When should you be careful with digoxin?

Caution in renal impairment, conduction disease and if on amiodarone

17

Drugs which improve survival rate?

ACEi
Beta-blockers
Spironolactone
Eplerenone
Hydralazine in combination with nitrates

18

What does GTN do?

Reduces pulmonary congestion
Low dose venodilation
High dose arterial vasodilation

19

What does morphine do?

Relieves dysponea
Venous and arterial dilatation
Heart rate reduction

20

What does dobutamine do?

Increases HR, CO, diuresis, vasodilation