Heart Failure Flashcards
Congestive cardiac failure
A syndrome- not a single disease. Any pathologic process that affects the pumping action of the heart and therefore reduces the output, can lead to HF
What are the main causes of LHF?
Ischaemic heart disease/past MIs, cardiomyopathy, valvular disease
What are the main causes of RHF?
Secondary to LHF, cor pulmonale, congenital heat disease
Cor Pulmonale
If the lungs are hypoxic, one of the adaptive responses is that it causes vasoconstriction. This means that the right side of the heart is having to work harder to pump through these vasoconstricted vessels to the left side.
What are the signs and symptoms of LHF?
SOB, orthopnoea, PND, pulmonary oedema, tachycardia, fine crepitations, pleural effusion, S3 (‘gallop rhythm’)
PND =
Paroxysmal nocturnal dyspnoea
Gallop rhythm =
S3 + tachycardia
What are the signs and symptoms of RHF?
Peripheral oedema, elevated JVP, hepatomegaly, ascites, normal CXR usually
How would you treat HF caused by AF?
Digoxin or DC shock - to slow it down to give the heart tome to fill before emptying
What are the pharmacological interventions for heart failure?
A - ACEi’s
B - B - blockers
C - Ca2+ blockers
D - Diuretics
What is the management for acute heart failure?
L - Loop diuretics M - Morphine N - Nitrates O - Oxygen P - Position - sit them up
How should you approach b-blocker use in treating heart failure?
Start low, go slow
How does spironolactone work?
Aldosterone receptor antagonist
Which decides can you use in the treatment of HF?
Implantable cardiac defibrillators (ICD) - prevent sudden cardia death from a arrhythmias
Cardiac resynchronisation therapy (CRT) - (Aka biventricular pacing) 3 pacemakers inserted to force LV and RV to contract together
What are the x-ray appearances of pulmonary oedema?
Alveolar odema (bat wings’s)
B-lines (curly) - short parallel lines at the lung bases at costoohrenic angles
Cardiomegaly (>50% of the whole diameter)
Dilated prominent upper lobe vessels
E effusion (pleural) - complication
