HTN/HF Flashcards
(28 cards)
What are DDx for HTN + SOB
CHF Renal failure PE/DVT Liver dz A. fib.
When may BNP be diagnostic? otherwise what is it used for?
When a pt has a new onset of SOB Used as a prognosis tool
What imaging is recommended in a pt who presents with CHF?
- CXR if new onset, or acute 2. ECHO for inital eval 3. EF in pts with change in clinical status or had tx that may affect cardiac function
What may a CXR of a pt with CHF show?
B/l basal congestion Pleural effusion Cardiomegaly hilar congestion
Describe Systolic Dysfunction
HF w/ decreased or impaired EF (HFrEF) < 40 %
Describe Diastolic Dysfunction
Diastolic HF w/ normal or preserved EF (HFpEF) > 50 %
How is stage A HF described by the ACFF/AHA?
High risk for HF w/o structural heart dz or sx
How is stage B HF described by the ACFF/AHA?
Structural heart dz w/o s/s of HF
How is stage C HF described by the ACFF/AHA?
Structural heart dz w/ prior or current sx of HF.
How is stage D HF described by the ACFF/AHA?
Refractory HF requiring specialized interventions
How is class I HF described by the NYHA
(Mild): No limitations, asymptomatic
How is class II HF described by the NYHA
(Mild): Slight limitation w/ physical activity, sx w/ ordinary activities, comfortable at rest
How is class III HF described by the NYHA
(Moderate): Marked limitation; symptomatic with less than ordinary activities, comfortable at rest
How is class IV HF described by the NYHA
Unable to carry on any physical activity w/ sxs, sx at rest
Stage C is usually associated with class __ and ___ from the NYHA
2, 3
Stage D is mostly defined as ___ from the NYHA
4
What is considered risk actors for HF?
HTN Atherosclerotic dz DM obesity Met. syndrome
What can cause structural heart dz and may/may not cause sxs?
MI LVH Valvular dz
What are the goals of therapy and Tx for a pt with Stage A HF?
GOAL: Lifestyle changes TX: fix RFs (ACE/ARB, statins)
What are the goals of therapy and Tx for a pt with Stage B HF?
GOAL: Prevent HF sxs and further structural damage TX: ACEI/ARB, BB, Statins
What are the goals of therapy and Tx for a pt with Stage C HF w/ reduced EF?
GOAL: control sxs, prevent hospitalization and mortality TX: ACE/ARB (ARNI), BB, Aldosertone antagonist (spironolactone), Diuretic some pts: Hydralazine/ISDN, Digoxin
What are the goals of therapy and Tx for a pt with Stage AD HF?
GOALS: control sxs, reduce hospital remission, establish EOL goals Temporary IV inotropic support using: - Adrenergic agonists (Dopamine, Dobutamine) - PDE Inhibitor (Milrinone) Transplant Palliative care LVAD
What are examples of AECI
Enalapril Lisinopril Captopril
What are examples of ARBs
Losartan Valsartan Candesartan
