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Flashcards in Heart Failure Deck (35)
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1

Heart failure definition

Cardiac output inadequate for body requirements

2

Systolic heart failure definition

Inability of ventricles to contract properly

3

Systolic heart failure ejection fraction

< 40%

4

Causes of systolic heart failure

IHD

MI

Cardiomyopathy

5

Diastolic heart failure definition

Inability of the ventricle to relax and fill properly

Increased filling pressures

6

Diastolic heart failure ejection fraction

> 50%

7

Causes of diastolic heart failure

Constrictive pericarditis

Tamponade

Restrictive cardiomyopathy

HTN

8

Types of heart failure

Systolic heart failure

Diastolic heart failure

 

Usually co-exist

9

Categories of heart failure

Left sided

Right sided

Congestive Cardiac Failure (L+R)

10

Acute heart failure / Acute decompensation of chronic heart failure Sx

Pulmonary / peripheral oedema

+/- peripheral hypoperfusion

11

Chronic heart failure

Develops slowly

Arterial pressure well mantained until late

12

Low output heart failure definition

Low CO

Fails to increase on exertion

13

Causes of low output heart failure

Pump failre

Excessive preload

Chronic excessive afterload

14

Causes of excessive preload

MR

Fluid overload

15

Causes of chronic excessive afterload

AS

HTN

16

High output heart failure definition

Rare

Normal CO

Body requirements still not met (eg. greater demand)

17

Causes of high output heart failure

Anaemia

Pregnancy

Hyperthyroidism

Paget's disease

Beri beri

18

Presentation of high output heart failure

Initially RVF

Later LVF

19

Diagnosis of heart failure

Framingham criteria:

- 2 major OR

- 1 major + 2 minor

20

Major Framingham criteria

PND

Crepitations

Cardiomegaly

Raised JVP

Acute pulmonary oedema

21

Minor Framingham criteria

Bilateral ankle oedema

SOB on normal exertion

Tachycardia > 120

Nocturnal cough

Hepatomegaly

Pleural effusion

22

Ix for heart failure

ECG + BNP

Echo if either are abnormal

23

Mx of chronic heart failure

Conservative

Medical

24

Conservative Mx of chronic heart failure

Stop smoking

Reduce salt intake

Weight loss

25

Medical Mx of chronic heart failure

Diuretics / Spironolactone

ACEi / Vasodilators

Beta blocker

Digoxin

26

New York classification of heart failure

I: No SOB on normal activity

II: SOB on normal activity

III: SOB on minor activity

IV: SOB at rest

27

BNP

B-type Natriuretic Peptide

28

BNP level to diagnose heart failure

> 100 ng/L

29

BNP level to rule out heart failre 

< 50 ng/L

30

Causes of RVF

-  LVF
- Cor pulmonale
- Tricuspid and pulmonary valve disease

31

Cor pulmonale definition

RVF due to lung disease / pulmonary HTN

32

Right ventricular failure signs

↑JVP
Hepatomegaly
Oedema
Ascites

Nausea

33

Left ventricular failure causes

IHD
Idiopathic dilated cardiomyopathy 
Systemic HTN
Mitral and aortic valve disease

34

Left ventricular failure Symptoms

SOB

Orthopnoea + PND

Nocturnal cough (± pink, frothy sputum)

Cardiomegaly

Bibasal creps

(Pulmonary oedema)

35

Acute mx of heart failure / pulmonary oedema

Position pt sitting up

O2

Nitrates

Morphine + anti-emetic

Loop diuretic