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What are the three aims of treatment?

Treat the cause (arrythmias), the exacerbating factors (anaemia thyroid disease, high BP) and avoid exacerbating factors (NSAIDs 10 fold risk and vermapril)


What drugs are used?

Diuretics, ACEIs, beta blockers, spironolactone (k sparing but no effect when balanced out by ACEIs), digoxin, vasodilator (hydralazine, isorbidide dinatrate)


What do you do if patient has intractable HF

Reassess cause, stronger drugs, bed rest, Na restriction, loop diuretics, daily wight and U+Es (test for hypokalemia), DVT prophylaxis with heparin and TED stockings


What is NY class 1 HF?

Heart disease but no dyspnoea from daily activities


What is NY stage 2?

Comfortable at rest, dyspnoea during ordinary activity


What is NY stage 3?

Limiting dyspnoea (occurs at level below normal activities)


What is NY stage 4?

Dyspnoea at rest, all activity causes discomfort


What lifestyle factors must be modified?

Smoking, salt intake, weight, nutrition