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20 Cards in this Set

  • Front
  • Back
If ACEI and beta blockers are good for treating inappreopriate neurohumoral activation; and Angiotensin receptor blockers and beta blockers are good when ACEIs are intolerated; is ACEI + ARB + beta blocker the best?
these patients do worse
use only 2
NYHA Class 1 for heart failure?
NYHA Class 2?
Class 3?
class 4?
class 1- no sx
class 2- sx w/ ordinary activity
class 3- sx w/ less than ordinary activity
class 4- sx at rest
what improves exercise capacity in patients with systolic failure without increasing mortality
early in a patient's course of heart failure addition of ___ may be adquate to relieve fluid retention by increasing forward flow
addition of ___ has been shown to further reduce the need for admission to the ER for acute diuresis
as heart failure progresses and cardiac output falls,___ become necessary for symptomatic relief
diuretics- loop are good but may cause hypokalemia; potassium sparing are good but may cause hyperkalemia w/ ACEI present
en end-stage heart failure- where the patient is typically experiencing intolerable sx at rest), the use of low-dose ___ (to improve forawrd flow and renal perfusion) and ___ (a venodilator) become essential
who usually dies of sudden arrhythmic death, class 2 or class 4 patients
class 2 patients
class 4 patients end up suffering lingering ends
what class of drug is most important at reducing the risk of sudden death
beta blockers
name five conditions that put patients at high risk for the development of heart failuare and should be treated aggressively
uncontrolled hypertension
untreated lipid disorders
valvular disease
thyroid disease
what is the first rule in treating heart failure
make sure left ventricular dysfunction is present- use an objective measure (ECG) to rule out anything that can mimic heart failure
what does "classify the type of LV dysfunction" mean and how do you do it?
determine if its systolic or diastolic dysfunction
ECG, nucleotide study, angiogram! (better do it)
What is the leading cause of diastolic dysfunction
treate aggressively
what is essential for all patients with systolic dysfunction
afterload reduction with aFCEI
BP should be normal
reduce ETOH intake
inc K intake
avoid NSAIDS
systolic dysfunction
class 1: drug?
class 2: ?
class 3: ?
class 4?
class 1- ACEI
class 2- beta blocker
class 3- beta blocker and digoxin and spironolactone
class 4- beta blocker, digoxin, transplant?
what is the most common iatrogenic error in heart failure management
inducing symptomatic bradycardia with excessive beta blockade
- patient may describe new dyspnea upon exertion
iatrogenic hypokalemia is from...
excessive diuresis
iatrogenic hyperkalemia is from...
K-sparing diuretic and ACE-I
iatrogenic induction of acute renal failure is from...
combining NSAID with ACEI
to avoid digoxin toxicity...what is the goal serum level
between 0.5-0.8 ng/mL