Flashcards in Heart Failure Deck (30)
What percentage of patients dies within 5 years of diagnosis
Prevalence in general population is?
Prevalence in the elderly?
What is systolic failure?
Inability of the ventricle to contract properly resulting in reduced CO and a EF of less than 40%
What are the common causes of systolic failure?
IHD, MI, Cardiomyopathy
What is diastolic failure?
Inability of the ventricle to relax properly resulting in increased filling pressures and an EF of greater than 50%
Causes of diastolic failure?
Cardiac tamponade, restrictive cardiomyopathy, constrictive pericarditis, hypertension
Systolic and diastolic failure are mutually exclusive, true or false?
False, they normally co-exist
When left ventricular and right ventricular failure co-exist, it is known as what?
Congestive cardiac failure
What are the symptoms of left sided heart failure?
Dyspnoea, poor exercise tolerance, fatigue, orthopnoea, paroxysmal nocturnal dyspnoea, nocturnal cough (may have pink frothy sputum), wheeze, nocturia, cold peripheries, weight loss and muscle wasting
Symptoms of right sided failure include?
Peripheral oedema, ascites, nausea, anorexia, facial engorgement, elevated JVP, pulsation on neck and face
Causes of right sided heart failure include?
Pulmonary stenosis, lung disease and LVF
What does acute heart failure refer to?
New onset or sudden de compensation of chronic heart failure leading to pulmonary/peripheral oedema with or without peripheral hypoperfusion
How is venous return effected compared to arterial pressure in chronic heart failure?
Arterial pressure is maintained until very late whereas venous congestion occurs much earlier
What is low output failure?
Low CO which fails to increase normally upon increased exertion
What are the three main mechanisms of failure in low output heart failure?
Pump failure, excessive preload and chronic excessive afterload
Give to causes of pump failure
Systolic/diastolic heart failure and decrease in heart rate due to drugs, MI or heartblock
Give to causes of excessive preload
Fluid overload and mitral regurgitation
Give to causes of excessive afterload
Aortic stenosis or hypertension
What is high output failure?
Abnormally high demand from the body means that the normal/increased CO is not sufficient
Causes of high output failure?
Anaemia, thyrotoxicosis, pregnancy and Paget's disease
In high output failure, which side fails first?
The right side of the heart
What criteria system is used to diagnose HF?
How many of the Framingham criteria must be met?
2 major or 1 major and two minor
Name 5 of the major criteria from the Framingham criteria
Crepitations, S3 gallop, cardiomegaly, increased CVP, Raised JVP
What are the two main investigations?
ECG and B type naturetic peptide
BNP level indicates what?
How sensitive is BNP testing?
If either of the two main tests are abonormal, what is the next test?
Echocardiogram (this is the key test for HF and may reveal the cause)