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Heart Failure mind maps
Heart Failure revision notes
Pathophysiololgy
Heart Failure with reduced ejection fraction (HFrEF)- EF < 50%.
Heart Failure with preserved ejection fraction (HFpEF)
up regulation of Renin-Angiotensin-Aldosterone System
Increased catecholaemines
Cardiomyopathies
valve disease
Investigaitons
Bloods
:
Natriuretic peptides- BNP / NTproBNP.
Renal function - renal dysfunction common
Haemoglobin- exclude anaemia
ECG
Atrial fibrillation
QRS + sinus rhythm + EF <35% + NYHA >II- CRT
CXR
upper lobe diversion
cardiomegaly
alveolar oedema/ interstitial oedema= Kerly B lines, patchy opacification
Pleural effusions
ECHO
Ejection fraction
valve disease
cardiomyopathy (dilated)
differential diagnosis- pericardial effusion/ constriction, cor pulmonale
Other tests
Angiography- ? IHD
MRI- structure and function
Radionucleotide - ? function
Biopsy
Clinical features
Symptoms- SOB/fatigue/ oedema
NYHA
(New York Heart Association):
I
= no limitation of physical activity
II
= Mild symptoms on exertion
III
= marked symptoms on exertion
IV
- symptoms at rest
PND
- paroxsysmal nocturnal dyspnoea
Orthopnoea
Peripheral oedema
SIGNS
Peripheral oedema
Raised JVP
Third heart sound
Displaced Apex
pulmonary crackles / wheeze
tachycardia
Management- Chronic
HFrEF
A
-
ACE inhibitor/ ARB
- all patients, improves life expectancy,
reduces hospitalisations
B
-
Beta blocker
- all patients, improves life expectancy , reduces hospitalisations
C
- Cardioverter defibrillator (
ICD) / CRT
(cardiac resynschronisation) - EF <35% plus NYHA II-IV
D
-
Diuretics
-loop +/- thiazide if persistent pedema- for
symptom relief
E
- everything else-
MRA
(mineralocorticoid receptor antagonists)- spironolactone/ eplerenone.
HFLN
(heart failure liaison nurses).
Ivabradine
HFpEF
No proven treatment to reduce mortality
Diuretics for symptoms
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Home
Medicine Notes
Surgery
Cardiology
Neurology
Obstetrics and gynaecology
gastroenterology
Haematology
Respiratory
Endocrinology
Nephrology
Psychiatry
Paediatrics
Rheumatology
Clinical Examination
Contact
eBook