Shortness of Breath Flashcards
(13 cards)
What should be on the differential in dyspnea on exertion?
CHF< angina, COPD, anemia, hypothyroid, metabolic acidosis, anxiety and hyperventilation
Sudden episodes of dyspnea NOT related to exertion whould make you think of what three diagnoses?
PE, pneumothorax, anxiety
What is trepopnea?
dyspnea when lying on side (seen in CHF)
What are some causes of left ventricular failure?
CAD, valvular disease, hypertension, congenital defects
What are common causes of right ventricular failure?
most commly left heart failure
also tricuspid regurgitation, mitral stesnosis, primary pulmonary hyeprtension, multiple pulmonary emboli, pulmonary valve stenosis, RV infarction
High output failure from anemia, beriberi, thyrotoxicosis, pregnancy and AV fistulas will eventually result in what?
ventricualar dysfunction
How do systolic and diastolic dysfunction differ?
systolic = ventriular contractile dysfunciton (EF decreased) diastolic = prolonged ventricular relaxation time and resistance to filling (stiff, EG preserved)
WHat drugs an you use to decrease preload in CHF?
diuretics, vasodilators
but by themselves they do not increase survival
What drugs can we use to increase contractility in CHF. which is oral and which is IV?
oral - digoxin
IV - dobutamine
What are two neurohumeral treatments for CHF?
spironolactone (aldosterone antagonist)
carvedilol (selective beta blocker)
Diruetics and vasodilators are contraindicated in what type of failure?
diastolic dysfunction -they can’t tolerate the decreasein plasma volume or BP
What can you use in diastolic dysfunciton them?
ace inhibitors
beta blockers to slow heart and allow more time for filling
What are the four general reasons (mechanisms) for leg edema?
- increased capillary pressure
- reduced lymphatic clearance
- Decreased capillary oncotic pressure (liver, renal disease - low albumin)
- increased capillary permeability
