Flashcards in CVS - Heart Failure Management Deck (5)
Give the classic signs and symptoms of chronic heart failure
- pulmonary congestion
- venous congestion
- dependent oedema
How can we test for chronic heart failure from visible signs?
Prominent JVP and pitting oedema
Describe the 'vicious cycle of heart failure'
- decreased CO and SV leads to decreased renal perfusion, so kidneys think the body is losing blood
- kidneys increase sodium/water retention (via RAAS and vasopressin) and therefore blood volume, which increases preload and filling pressure
- this leads to ventricular dilatation and increased wall stress, which compounds CO/SV problems
- decreased renal perfusion also activates neurohormonal systems which cause an increase in systemic vascular resistance and outflow resistance, impairing the function of the left ventricle
What are the two main classes of drug used to treat heart failure?
- beta-blockers, which target the sympathetic nervous system
- RAAS inhibitors (ACEI, ARB, MRA), which target the renin-angiotensin-aldosterone system