Heart Failure Flashcards Preview

Jamie Cardiovascular Pathology > Heart Failure > Flashcards

Flashcards in Heart Failure Deck (30):
1

What is heart failure?

A clinical syndrome comprising of dyspnoea, fatigue or fluid retention due to cardiac dysfunction

2

What are 4 clinical risk factors of chronic heart failure?

Hypertension
Diabetes
Obesity
Coronary heart disease

3

What are 3 symptoms of heart failure?

Breathlessness
Fatigue
Oedema

4

What are 4 signs on examination of heart failure?

Tachycardia
Raised JVP
Chest crepitations/effusions
3rd heart sound
Displaced/abnormal apex beat

5

What are 2 screening tests that can be performed for heart failure?

ECG
BNP (brain natriuretic peptide) measurement

6

How does BNP react in heart failure?

BNP is elevated

7

What condition of heart failure is unlikely with a normal ECG?

Left ventricular systolic dysfunction

8

What investigation should be performed when an elevated BNP is identified?

ECHO

9

What do structural cardiac abnormalities usually lead to?

Heart Failure

10

What are the 4 primary causes of LVSD?

Ischaemic heart disease
Aortic valve disease
Mitral regurgitation
Dilated cardiomyopathy (all secondary causes not related to IHD or valves)

11

How can disease affect the LV ejection fraction?

Can either increase or decrease it

12

What investigation can be used to determine LV ejection fraction?

ECHO

13

What percentage is a severe LV ejection fraction?

14

What scan other than ECHO can be used to identify LV ejection fraction?

MUGA scan

15

What is it is involved in systolic heart failure?

Decreased pumping function resulting in fluid back up in lungs and heart failure?

16

What is it is involved in diastolic heart failure?

The heart muscle thickens and becomes stiff causing the heart not to fill with blood properly resulting in fluid backup of the lungs and heart failure

17

What are the 2 (salt and waters retaining and vasoconstriction) systems involved in the neuroendocrine response to heart failure?

The renin-angiotensin-aldosterone system
The sympathetic system

18

What are the 2 (salt and waters excretion and vasodilation) systems involved in the neuroendocrine response to heart failure?

Natriuretic peptide system
ERDF

19

What are the 3 drugs that are used to improve the symptoms of heart failure?

Diuretics
Digoxin
ACE inhibitors/ARBs

20

What are the 4 drugs that are used to improve the survival of heart failure?

ACE inhibitors/ARBs
B Blockers
Ivabradine
Spironolactone`

21

What are the 3 aims of symptomatic treatment of heart failure?

Inhibition of detrimental neurohormonal adaptions
Enhancement of beneficial neurohormonal adaptions
Enchancement of cardiac function

22

What is the main drug type for symptomatic treatment of heart failure?

Loop diuretics

23

What is the main drug used for loop diuretics?

Furosemide

24

What are 4 adverse drug reactions of loop diuretics?

Dehydration
Hypotension
Hypokalaemia
Gout

25

What drugs should furosemide not be used with? (5)

Aminoglycosides
Lithium
NSAIDs
Antihypertensives
Vancomycin

26

What is spironolactone an example of?

An aldosterone antagonist

27

What should spironolactone be used with to reduce mortality of heart failure patients?

ACEI

28

When should B blockers be used in heart failure?

Once a patient has been stabilised not during acute presentation (and only by specialists)

29

What are 2 examples of B blockers

Carvedilol
Bisoprolol
Metoprolol

30

What is the typical therapeutic regime (in order) for treating heart failure?

Furosemide (loop diuretic)
ACEI
B blocker
(Digoxin or Warfarin in special cases)