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Cardiology > Heart Failure > Flashcards

Heart Failure Flashcards

1
Q

Define HF

A

Cardiac output is inadequate for body’s requirements

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2
Q

Define systolic failure

A

Inability of ventricle to contract normally, resulting in decreased cardiac output

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3
Q

Define diastolic failure

A

Inability of ventricle to relax and fill normally, causing increased filling pressures

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4
Q

What is HFpEF?

A

Heart failure with preserved EF

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5
Q

What is CCF a combination of?

A

LVF and RVF

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6
Q

Define acute HF

A

New-onset acute or decompensation of chronic HF characterised by pulmonary and/or peripheral oedema with or without signs of peripheral hypoperfusion

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7
Q

Define chronic HF

A

Develops or progresses slowly

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8
Q

What are some causes of SF?

A

IHD, MI, Cardiomyopathy

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9
Q

What are some causes of DF?

A

Aortic stenosis, chronic HTN

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10
Q

What are some causes of RHF?

A

Right ventricular infarct, PH, PE, COPD, LHF, Cor pulmonale

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11
Q

How does LVF present?

A

Dyspnoea, fatigue, orthopnoea, poor exercise tolerance, nocturnal cough, wheeze, nocturia, cold peripheries

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12
Q

How does RVF present?

A

Peripheral oedema, ascites, nausea, facial engorgement, epistaxis

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13
Q

What is epistaxis?

A

Nose bleed

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14
Q

What are signs of general HF?

A

Elevated JVP, 3rd or 4th heart sounds, displaced apex beat, murmurs, bibasal crackles

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15
Q

What criteria do you use for CCF?

A

Framingham criteria

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16
Q

What two tests would you do first?

A

ECG and B-type natriuretic peptide

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17
Q

Where is BNP secreted from?

A

Ventricular myocardium

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18
Q

What causes an increase in plasma BNP?

A

MI, LV dysfunction, tachycardia

19
Q

How do ANP and BNP work?

A

They help stretched atria and ventricles by increasing GFR, decreasing Na+ reabsorption, relaxing smooth muscle

20
Q

What is the overall effect of ANP and BNP?

A

Reduced fluid load and preload

21
Q

When would you do an echo?

A

If ECG or BNP are abnormal

22
Q

What signs can you see on a CXR in LVF?

A

ABCDE. Alveolar oedema (Bat’s wings), kerley B lines, Cardiomegaly, Dilated prominent upper lobe vessels, pleural Effusion

23
Q

What lifestyle changes would you make in chronic HF?

A

Stop smoking and alcohol, eat less salt, optimise weight and nutrition

24
Q

What drug options do you have?

A

Diuretics, ACE-i, Beta-blockers, mineralocorticoid receptor antagonists, digoxin

25
Q

When would you consider ACE-i?

A

In all LVSD

26
Q

When would you give ARB?

A

If cough from ACE-i is a problem

27
Q

When would you add Digoxin?

A

In patients with LVSD

28
Q

What classification system is used for HF?

A

New York Classification of HF

29
Q

What is stage I?

A

Heart disease present with no undue dyspnoea from ordinary activity

30
Q

What is stage II?

A

Comfortable at rest, dyspnoea during ordinary activity

31
Q

What is stage III?

A

Less than ordinary activity causes dyspnoea, limiting

32
Q

What is stage IV?

A

Dyspnoea present at rest, all activity causes discomfort

33
Q

What can cause LHF?

A

Coronary artery disease, MI, Cardiomyopathy, Congenital heart defects, valvular heart disease, arrhythmias

34
Q

How do diuretics help?

A

They reduce preload and pressures on ventricles

35
Q

Give an example of an ACE-i

A

Ramipril

36
Q

Give an example of a beta-blocker

A

Bisoprolol

37
Q

Give an example of a mineralocorticoid receptor antagonist

A

Spironolactone

38
Q

Which diuretic/mineralocorticoid receptor antagonist is potassium sparing?

A

Spironolactone

39
Q

Give some examples of diuretics

A

Furosemide, bendroflumethazide, spironolactone

40
Q

What is the action of amlodipine?

A

Inhibition of L-type voltage gated calcium channel in the nephron

41
Q

What is the action of spironolactone?

A

Inhibition of aldosterone receptor in the distal tubules

42
Q

What is the action of thiazide-like diuretics?

A

Inhibition of the sodium chloride transporter in the distal convoluted tubule

43
Q

What is the action of furosemide?

A

Inhibition of the sodium/potassium/chloride symporter in the ascending limb of the loop of Henle

44
Q

What are the three cardinal signs of HF?

A

Shortness of breath, fatigue, ankle swelling

Cardiology (23 decks)

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