Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
14 Cards in this Set
- Front
- Back
|
What causes decreased stroke volume in heart failure? (2)
|
Decreased contractility and increased afterload
|
|
|
What 3 factors affect stroke volume (and CO)?
|
Preload
Afterload Contractility |
|
|
What causes congestion during acute heart failure?
|
Increased Preload
|
|
|
How do you diagnose acute HF?
|
History
Physical Ancillary testing: ECG, Bloodwork (CBC, renal function, troponin, electrolytes), CXR, heart angiogram/nuclear scan (if suspect ischemia), MRI |
|
|
What is the most common reason any patient is hospitalized?
|
Acute HF
|
|
|
What is the chance of being re-admitted to hospital within one year after HF?
|
25%
|
|
|
What are the general principals of treating acute HF?
|
Stablize
Identify (and fix) precipitating cause Restore normal physiology |
|
|
How do you stabilize a patient with acute HF? (5)
|
Elevate head of bed
Monitor vitals O2 Establish IV Positive pressure ventilation to prop lungs open |
|
|
What drugs make a patient feel better but do not improve survival in acute HF?
|
Diuretics (furosemide)
Morphine Digoxin Vasodilators (nitro, hyralazine) Inotropes (Dobutamine, Milrinone) |
|
|
How does morphine work to treat acute HF?
|
Pulmonary veno-dilation
Decreased sympathetic activation Decreased sensation of dyspnea ** |
|
|
How do inotropes work to treat HF?
|
Increase contractility and decrease afterload (increase CO)
Decrease preload (decrease congestion) |
|
|
What drugs do you give when a patient presents with acute HF?
|
Morphine
Loop diuretics Vasodilators Inotropes (only if have really low CO or cardiogenic shock) |
|
|
What drugs do you start once a patient with acute HF is stable?
|
ACEi (1st once stable)
Beta-blocker (2nd once compensated) |
|
|
What medications should you avoid in acute HF?
|
CCB
Anti-arrhythmic drugs NSAIDS |
