HF Flashcards
(32 cards)
Define HF
Cardiac output inadequate for requirements
what is the incidence of HF
1-3% but 10% in elderly
what is the 5 year survival for HF
25-50%
what are the causes of HF
- IHD 70% , Hypertension (5%)
- Non-Ischaemic Dilated Cardiomyopathy (25%)
- Other: valvular, congenital (VSD, ASD), AF, PE
what is the aetiological difference between mild, moderate and severe HF
Mild: ↓EF →↓CO and ↑HR
Moderate: ↑ venous pressure +↑HR= ↓CO
Severe: ↓CO even at rest
what is the cycle of heart failure
increased pre-load leads to increased cardiac work/myocardial damage leads to decreased CO which leads to RAAS activation that causes vasoconstriction and water retention leading to increased pre-load
Define congested HF
combination of L and F HF
define Systolic HF
: Ejection Fraction (EF)
define diastolic HF
: ↑ filling pressure with EF>50% i.e. tamponade HTN,
define High output HF
↑demand i.e. anaemia, pregnancy
define low output HF
failure to maintain CO
what are the main causes of Left HF
- IHD,
- Non-ischaemic dilated cardiomyopathy
- Hypertension
- Valvular: MS(HTN in RA)
what are the symptoms of L HF
- Fatigue (common)
- Exertional dyspnoea
- Orthopnoea / PND
what are the signs of L HF
- Apex displacement: cardiomegaly
- 3rd heart sound: galop rhythm
- Crackles in lung bases: Pulmonary oedema
- Pitting oedema
what are the causes of R HF
- Cor pulmonalis
- PE, pulmonary hypertension
- Tricuspid OR pulmonary valve disease
- ASD, VSD
- RV cardiomyopathy
what are the symptoms of R HF
• Fatigue, dyspnoea, anorexia, nausea
what are the signs of R HF
- ↑JVP
- Cardiomegaly and functional tricuspid regerge
- Hepatomegaly and ascitic
- Pitting oedema
what bloods would be useful in diagnosis of HF and why
↑BMP, FBC(anaemia), U&E (eGFR, ion stability), CVS ↑risk: Glucose (DM) Lipids, TFTs, LFTs (liver ascitis?)
What other investigations are useful in assessing HF and why
• CXR: cardiomegaly, pleural effusion
• ECGO if BMP >400pg/ml
o LV function, valves diastolic function
what factors other than HF raise naturetic peptide
o Chronic hypoxaemia o Renal dysfunction o Advanced age o Liver cirrhosis o Sepsis
What level on naturetic peptide warrens ECHO
> 100pm/ml
what is the NYHM scale of HF
classification of disability due to HF
what is class I NYHA
No limitation of physical activity
what is class II NYHA
Slight limitation of physical activity (symptomatically mild heart failure
