Heart Failure

Front 1

What is Heart Failure?

Back 1

Heart Failure is a condition in which the heart can't pump enough blood throughout the body

As a result, vital organs such as the brain, liver and kidneys are affected

Front 2

What are the leading causes of Heart Failure?

Back 2

1) Coronary Artery Disease
2) Hypertension
3) Diabetes
(High levels of lipid in the blood= atherosclerosis & hypertension)

Front 3

What is Cardiomyopathy?

Back 3

Damage to the heart muscle

Front 4

Pathophysiology of heart failure

Back 4

See chart

Front 5

The Renin-Angiotensin-Aldosterone System (RAAS) in heart failure

Back 5

See chart

Front 6

How does the Heart compensate?

Back 6

1) The heart muscle thickens to compensate for increased volume: Ventricular hypertrophy

2) It may enlarge, which allows more blood into the heart: Ventricular dilatation

3) It may contract more frequently to increase circulation

4) Activation of kidney's neurohormonal sytem: salt & water retention

Front 7

Symptoms?

Back 7

1) The heart's inability to pump blood and supply oxygen to organs
2) Congestion of the lungs with extra fluid
3)Lungs
- Dyspnea
- Orthopnea: Cant sleep at night

Front 8

What is Acute Heart Failure Syndrome? (AHFS)

Back 8

Is defined as gradual or rapid change in Heart Failure signs & symptoms resulting in a need for urgent therapyé

Front 9

What are the precipitating factors?

Back 9

- Concurrent cardiovascular conditions (CHD, Hypertension,)
- Diabetes
- Anemia

Front 10

What are the symptoms?

Back 10

- Sudden fluid build-up
- Rapid irregular heartbeat with palpitations that may cause the heart to stop beating
- Sudden , severe shortness of breath and coughing up pink, foamy mucus
- Chest pain if caused by MI

Front 11

Part of the heart affected by heart failure

Back 11

See Chart

Front 12

What are the Stages of Heart Failure Classification from NYHA (New York Heart Association)

Back 12

See Chart

Front 13

What is the newer classification system?

Back 13

American College of Cardiology Scale
(Uses letters A to D)

Stage A; A person who has several risk factors for heart failure

Stage D: A person with end-stage heart failure

Front 14

How is it diagnosed?

Back 14

1. History
2. Examination
3. Investigations
a- Blood tests: check kidneys and thyroid function
b- Specific chemical markers of heart failure: Brain Natriuretic peptide (BNP)

Front 15

Diagnose continued

Back 15

4. Chest X-Ray to check:
a- Condition of the lungs
b- Size of the heart

5. ECG
a- Heart rhythms problems
b- Size of the heart

6. Echocardiogram
- It helps determine the Ejection fraction

7. Strest test
8. Cardiac CT or MRI scans
9. Coronary catherization (Angiogram)

Front 16

How is is treated?

Back 16

1. ACE Inhibitors
2. Diuretics
3. Vasodilators
4. Digitalis preparations
5. Beta Blockers
6. Blood thinners
7. Angiotensin II Receptor Blockers
8. Calcium Channel Blockers
9. Cholesterol-Lowering Drugs

Front 17

How does Coronary Artery disease produce heart failure?

Back 17

The arteries become narrow or clogged, limiting blood supply to the heart

Front 18

How does Hypertension produce heart failure?

Back 18

Increased Blood Pressure causes the heart to overworked.

Front 19

How does Heart valve or Congenital heart defects produce heart failure?

Back 19

Increase volume or increase pressure leads to obstruction

Front 20

How does Arrhythmias produce heart failure?

Back 20

Abnormal heart rhythm causes heart to overwork

Front 21

Explain how Coronary artery disease produce heart failure?

Back 21

The arteries become narrowed or clogged, limiting blood supply to the heart

Front 22

Explain how hypertension produce heart failure?

Back 22

Increased BP causes the heart to go into tachycardia. Heart compensates too much (over works)

Front 23

Explain how Heart valve disease or Congenital heart defects produce heart failure?

Back 23

Increase volume or increase pressure leads to obstruction

Front 24

Explain how arrhythmias produce heart failure?

Back 24

Abnormal heart rhythm causes heart to overwork

Front 25

Explain how Diabetes produce heart failure?

Back 25

Increased lipids levels in the blood causes atherosclerosis and hypertension

Front 26

What are the symptoms of heart failure?

Back 26

Myocardial Infarction
Edema of lower limbs
Dyspnea

Front 27

What are the signs of Heart Failure?

Back 27

Sudden fluid build-up
Swollen or tender abdomen
Sudden weight gain

Front 28

Why is there dyspnea with heart failure?

Back 28

Increased pressure and/or extra fluid in the lungs

Front 29

Why is there oedema with heart failure?

Back 29

Systemic circuit can't return to heart, so it builds up in the legs (venous congestion)

Front 30

Why is there lack of appetite with heart failure?

Back 30

Due to a build up of fluid (congestion) around the liver & gut interfering with digestion

Front 31

What is Brain natriuretic peptide?

Back 31

It is a chemical marker that is secreted by the heart at high levels when it's injured or overworked

Front 32

Cite 3 medications used to treat heart failure?

Back 32

1) Beta-Blockers
2) ACE inhibitors
3) Diuretics

Front 33

What is the drug of choice to treat heart failure?

Back 33

ACE inhibitors (Cardura)

Front 34

Why are ACE inhibitors useful in heart failure?

Back 34

Dilate the blood vessels so blood can flow through more easily. ( lower BP= blocks the conversion of Angiotensin I into Angiotensin II)

Front 35

Cite 3 side effects of ACE inhibitors?

Back 35

1) Persistent cough
2) Weakness & dizziness
3) Altered sense of taste

Front 36

What category of medications do Lasix and Butamex belong to?

Back 36

Diuretics

Front 37

What is their mechanism of action?

Back 37

Help eliminate the extra water & sodium salt that causes swelling of the ankles, and shortness of breath

Front 38

Cite an important precaution with the use of such drugs?

Back 38

Important to eat food high in potassium because diuretics may cause loss of potassium

Front 39

Name a potassium sparing diuretic?

Back 39

Aldactone

Front 40

Why does a patient not need to take K+ supplements with Aldactione?

Back 40

Aldactone acts as an aldosterone antagonist meaning Na loss and K+ retention

Front 41

Cite a vasodilator?

Back 41

Apresoline

Front 42

What is their mechanism of action?

Back 42

Relaxes smooth muscles & widens blood vessels

Front 43

How do vasodilators produce "orthostatic hypotension"?

Back 43

Because vasodilators dilates arterioles & veins (abolish constriction)

Front 44

How does Digoxin (Lanoxin) improve the symptoms of heart failure?

Back 44

It increases the force of heart muscular and increases the COP. It also helps avoid rapid heart rhythms.

Front 45

Cite 2 precautions with the use of Lanoxin?

Back 45

1) Predispose to some arrhythmias
2) Hypokalcimia

Front 46

Cite the advantage of administering a Beta blocker to a person suffering from heart failure?

Back 46

The failing heart tries to compensate for its weakened pumping action by beating faster, which puts more strain on it. Beta blockers reduce the heart's tendency to beat faster

Front 47

Cite the name of two Angiotensin II receptor blockers?

Back 47

1) Micardis
2) Diovan

Front 48

Cite 2 side effects of these medications?

Back 48

Cough
High level of potassium

Front 49

What are the dual effects of Calcium channel blockers on heart failure?

Back 49

Lower BP
Increase Coronary blood flow

Front 50

Cite 3 side effects of calcium channel blockers?

Back 50

1) Headache
2) Dizziness
3) Drowsiness