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Cardiovascular system > Heart failure > Flashcards

Heart failure Flashcards

1
Q

what are 4 symptoms of heart failure

A

breathlessness
fatigue
oedema
reduced exercise capacity

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2
Q

what are signs of heart failure

A 
oedema
tachycardia
raised JVP
chest crepitations
chest effusions
3rd heart sounds
displaced apex beat
abnormal apex beat
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3
Q

what are the 4 main tests used for heart failure

A

ECHO
radionucleotide scan - invasive test
left ventriculogram
cardiac MRI

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4
Q

what are potential screening tests for heart failure

A

12 lead ECG

BNP

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5
Q

what is BNP screening

A

brain natriuretic peptide testing
it is a blood test
it measures levels of a protein called BPN

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6
Q

what is BPN

A

it is a protein made by your heart and blood vessels

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7
Q

what do high levels of BNP indicate

A

high levels are normal when you have heart failure

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8
Q

what will cause heart failure

A

any structural heart disease

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9
Q

state some structural heart diseases that cause heart failure

A 
left ventricular systolic dysfunction
left ventricular diastolic dysfunction
valvular heart disease
pericardial constriction
pericardial effusion
cardiac arrhythmias
myocardial ischaemia
myocardial infarction
restrictive cardiomyopathy
right ventricular failure
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10
Q

what is left ventricular systolic dysfunction

A

it is a condition that often leads to heart failure, it may either be asymptomatic or also have symptoms of heart failure

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11
Q

what is left ventricular systolic dysfunction characterised by

A

dilation of the left ventricle and also by vasoconstriction

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12
Q

what are the 4 main causes of left ventricular systolic dysfunction

A

ischaemic heart disease
severe aortic valve disease
severe mitral valve regurgitation
dilated cardiomyopathy

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13
Q

what is aortic valve disease

A

it is a condition in which the valve between the left ventricle and the aorta doesn’t work properly

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14
Q

what is dilated cardiomyopathy

A

it is a condition in which the heart’s ability to pump blood is decreased because the heart’s left ventricles is enlarged and weakened

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15
Q

in some cases what does dilated cardiomyopathy prevent

A

the heart from relaxing and filling with blood as it should

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16
Q

what are investigations of heart failure

A 
ECG
CXR
ECHO
CT coronary angiogram
cardiac MRI

most patients should be assessed by a cardiologist

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17
Q

what is the modern pharmacological treatment of heart failure, this is heart failure due to left ventricular systolic dysfunction

A 
diuretics (furosemide)
ACE inhibitors (ramipril)
ARBs
beta blockers (carvedilol)
aldosterone receptor blockers (spironolactone)
ARNI's (entresto)
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18
Q

what are symptoms of NYHA class 1 heart failure

A

no exercise tolerance

no symptoms during usual activity

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19
Q

what are symptoms of NYHA class 2 heart failure

A

mild limitation of exercise tolerance

comfortable with rest or with mild exertion

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20
Q

what are symptoms of NYHA class 3 heart failure

A

moderate limitation of exercise tolerance

comfortable only at rest

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21
Q

what are symptoms of NYHA class 4 heart failure

A

severe limitation of exercise tolerance

any physical activity brings discomfort and symptoms occur at rest

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22
Q

what are the main treatments for heart failure

A

healthy lifestyle changes
medication
devices implanted in your chest to control your heart rhythm
surgery

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23
Q

what are lifestyle changes recommended

A 
stopping smoking
eating healthily
moderating alcohol consumption
cutting down salt intake
regular exercise
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24
Q

how are lifestyle changes a form of treatment for heart failure

A

lifestyle changes can help relieve your symptoms and can reduce your risk of becoming seriously ill

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25
what are some of the medications for heart failure
``` ACE inhibitors beta blockers angiotensin receptor blockers hydrazine with nitrate diuretics aldosterone antagonists sacubitril valsartan ivabradine digoxin ```
26
how are ACE inhibitors medication for heart failure
they work by relaxing and opening up your blood vessels | makes it easier for your heart to pump blood around the bod
27
what are side effects of ACE inhibitors as a medication for heart failure
dry cough is a common side effect cause blood pressure to fall too low sometimes may cause kidney problems
28
describe beta blockers as medication for heart failure
beta blockers work by slowing your heart rate down, they protect your heart from the effects of adrenaline and noradrenaline beta blockers protect against fight or flight chemicals produced by the body
29
what are possible side effects of beta blockers as medication for heart failure
dizziness tiredness blurred vision
30
describe angiotensin receptor blockers as medication for heart failure
work in a similar way the angiotensin converting enzyme inhibitors, they relax blood vessels and reduce blood pressure
31
when are angiotensin receptor blockers used as medication for heart failure
they are used as an alternative for ACE inhibitors, however, they are not as effective however angiotensin receptor blockers do not cause cough
32
what are possible side effects of angiotensin receptor blockers as medication for heart failure
low blood pressure and high levels of potassium in your blood are possible side effects
33
describe hydrazine with nitrate as medication for heart failure
hydrazine with nitrate in combination can help relax and open up the blood vessels
34
what are possible side effects of hydrazine with nitrate as medication for heart failure
side effects can include headaches, a fast heartbeat and palpitations
35
what are diuretics
they are water pills, drugs that make you pass more urine
36
what do diuretics help relieve
ankle swelling and breathlessness
37
what are possible side effects of diuretics
dehydration and reduced levels of sodium and potassium in the blood
38
what is heart failure caused by
many conditions that damage the heart muscle, including coronary heart disease
39
list conditions that can lead to heart failure
``` coronary heart disease high blood pressure cardiomyopathy arrhythmias damage or other problems with the heart valves congenital heart disease anaemia excessive alcohol consumption overactive thyroid pulmonary hypertension ```
40
state 3 common symptoms of heart failure
breathlessness fatigue swollen ankles and legs
41
state less common symptoms of heart failure
``` persistent cough wheezing bloated tummy loss of appetite weight gain weight loss confusion dizziness fainting fast heart rate palpitations ```
42
state 5 tests for heart failure
``` blood tests ECG ECHO breathing tests CXR ```
43
what is chronic heart failure characterised by
``` progressive cardiac dysfunction breathlessness tiredness neurohormonal disturbances sudden death ```
44
define heart failure
it is the state in which the heart is unable to pump blood at a rate commensurate with the requirements of the tissues or can do so only from high pressures
45
state 2 types of heart failure
systolic heart failure | diastolic heart failure
46
what is systolic heart failure
decreased pumping function of the heart, which results in fluid back up in the lungs and heart failure
47
what is diastolic heart failure
it involves a thickened and stiff heart muscle - the heart does not fill with blood properly
48
what does diastolic heart failure result in
fluid backup in the lungs and heart failure
49
what does systolic heart failure result in
fluid back up in the lungs and heart failure
50
what are the major risk factors associated with heart failure and coronary artery disease
``` a history of previous myocardial infarction hypertension valvular heart disease alcoholism diabetes congenital heart defects ```
51
what are additional heart failure risk factors
``` obesity age reduced/falling vital capacity smoking high/low haematocrit level ```
52
describe frank starling law in relation to systolic dysfunction
the strength of the heart's systolic contraction is directly proportional to its diastolic expansion with the result that under normal physiological conditions the heart pumps out of the right atrium all the blood returned to it without letting any back up in the veins
53
what does the renin angiotensin aldosterone system cause the release of
angiotensin 2 and aldosterone
54
what is pulmonary oedema
it is a condition caused by excess fluid in the lungs, the fluid collects in the alveoli - making it difficult to breathe
55
what are the 2 goals of heart failure management
improve symptoms | improve survival
56
what is the treatment to improve symptoms of heart failure
diuretics and digoxin
57
what is the treatment to improve survival of heart failure
beta blockers and ivabradine
58
what is the treatment to improve symptoms and survival together of heart failure
ACE inhibitors ARBs spironolactone valsartan-sacubitril
59
what is a loop diuretic
it is a diuretic which inhibits resorption of water and sodium from the loop of Henle
60
state 2 adverse drug reactions with diuretics
Severe dehydration | development of gout
61
state 4 treatments to reduce mortality relating to heart failure
angiotensin blockade beta receptor blockade aldosterone blockade atrial and brain natriuretic peptide enhancement
62
state 3 angiotensin converting enzyme inhibitors
ramipril enalapril lisinopril
63
what are beta blockers
any of a class of drugs which prevent the stimulation of the adrenergic receptors responsible for increased cardiac action, used to control heart rhythm, treat angina and reduce high blood pressure
64
what are positive inotropes
agents that increase the strength of muscular contraction, increase the quantity of intracellular calcium available for binding by muscle proteins, increase the sensitivity of contractile proteins to calcium

Cardiovascular system (34 decks)

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