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19 Cards in this Set
- Front
- Back
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DDx for dyspnea on exertion:
HAAAM CO |
Hypothyroid
Anemia Angina Anxiety and Hyperventilation Metabolic Acidosis Congestive Heart Failure Obstructive Airway Disease Obstructive Airway Disease |
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Orthopnea - dyspnea when _____
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supine - as in CHF, asthma, COPD
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Paroxysmal noctural dyspnea - waking at night short of breath as in what two conditions that start with acronym C
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Chronic Heart Failure
COPD |
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Trepopnea - dyspnea when doing what. What condition?
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laying on side
CHF |
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What is a syndrome of dyspnea on exertion, edema of the lungs or extremities and fluid retention resulting from cardiac dysfunction
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Congestive Heart Failure
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What are the three determinents of stroke volume?
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Preload
Contractility Afterload |
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Why is adrenergic stimulation controversial in heart failure?
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It helps contractility, but it also increases afterload (vascular resistance) and may cuase arrhythmias
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Neurohormone secreted from the cardiac ventricles in response to volume expansion and pressure overload.
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B-type natriuretic peptide (BNP)
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If someone has dyspnea and BNP levels come back high - what can you diagnose?
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Chronic Heart Failure
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NY Heart Association Functional Classification - what's the difference between Class I and Class IV
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Class I - no limitation on physical activity
Class IV - symptoms at rest, can't carry on any physical activity without symptoms |
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Which test is the gold standard to distinguish cardiac heart failure
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Cardiac echo - indicates Left Ventricular Failure and decreased ejection fraction
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What two drug classes work on Preload?
Do they improve survival? |
Diuretics
Vasodilators (venoselective) NO - not by themselves |
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Which two drug classes work on increasing myocardial contractility?
Do they improve survival? |
Digoxin
Dobutamine Digoxin reduces morbidity when also on diuretics and ACE inhibitors |
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What three drug classes work on afterload treatment?
Do they improve survival? |
Arterial vasodilators
ACE inhibitors Angioreceptor II receptor blockers YES! ACE inhibitors do big time... also ARBs |
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What are two Neurohumeral Treatments?
Do they improve survival? |
Spironolactone - aldosterone antagonist
Carvedilol - selective beta blocker Both - yes! |
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How is BNP used - what is the drug name?
What is the major side effect? |
Nesiritide
Needs to be infused Very expensive used for stage IV heart failure Hypotension |
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What drugs are contraindicated for diastolic dysfunction?
What is the best drug to use for diastolic dysfunction? |
Preload drugs... Diuretics and vasodilators (pts don't tolerate lowered plasma volume or BP)
Beta blockers |
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Hepatomegaly can be a sign of what?
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Right ventricular heart failure
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What aspect of SV does Enalapril work on?
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An afterload reducer - ACE inhibitor's direct effect is vasodilation of the arteries and veins
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