Flashcards in Heart Failure Deck (30):
1
What percentage of patients dies within 5 years of diagnosis
25-50%
2
Prevalence in general population is?
1-3%
3
Prevalence in the elderly?
~10%
4
What is systolic failure?
Inability of the ventricle to contract properly resulting in reduced CO and a EF of less than 40%
5
What are the common causes of systolic failure?
IHD, MI, Cardiomyopathy
6
What is diastolic failure?
Inability of the ventricle to relax properly resulting in increased filling pressures and an EF of greater than 50%
7
Causes of diastolic failure?
Cardiac tamponade, restrictive cardiomyopathy, constrictive pericarditis, hypertension
8
Systolic and diastolic failure are mutually exclusive, true or false?
False, they normally co-exist
9
When left ventricular and right ventricular failure co-exist, it is known as what?
Congestive cardiac failure
10
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
11
Symptoms of right sided failure include?
Peripheral oedema, ascites, nausea, anorexia, facial engorgement, elevated JVP, pulsation on neck and face
12
Causes of right sided heart failure include?
Pulmonary stenosis, lung disease and LVF
13
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
14
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
15
What is low output failure?
Low CO which fails to increase normally upon increased exertion
16
What are the three main mechanisms of failure in low output heart failure?
Pump failure, excessive preload and chronic excessive afterload
17
Give to causes of pump failure
Systolic/diastolic heart failure and decrease in heart rate due to drugs, MI or heartblock
18
Give to causes of excessive preload
Fluid overload and mitral regurgitation
19
Give to causes of excessive afterload
Aortic stenosis or hypertension
20
What is high output failure?
Abnormally high demand from the body means that the normal/increased CO is not sufficient
21
Causes of high output failure?
Anaemia, thyrotoxicosis, pregnancy and Paget's disease
22
In high output failure, which side fails first?
The right side of the heart
23
What criteria system is used to diagnose HF?
Framingham criteria
24
How many of the Framingham criteria must be met?
2 major or 1 major and two minor
25
Name 5 of the major criteria from the Framingham criteria
Crepitations, S3 gallop, cardiomegaly, increased CVP, Raised JVP
26
What are the two main investigations?
ECG and B type naturetic peptide
27
BNP level indicates what?
Myocardial stretch
28
How sensitive is BNP testing?
>90%
29
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)
30