Left-sided HF present with […] edema
Pulmonary 🫁
Right-sided HF present with […] edema
Peripheral 🦵🏼
Signs of Right-sided HF
- JVD
- Hepatomegaly / Hepatojugular reflux
- Ascites
Medications for CHF that lowers mortality
💊 ACE-i
💊 ß-blocker
💊 Spironolactone
What medication most effective for symptomatic relief of congestion in CHF ?
Diuretics
Drug of choice for
CHF NYHA class I
ACE-i/ARBs
Diuretics (loop) for symptoms
Drug of choice for
CHF NYHA class II
add ß-blocker
Drug of choice for
CHF NYHA class I
Add MRA (spironolactone)
Digoxin
Medications that can be used for EF<35
and are shown to improve mortality :
MRAs
LCZ696 (ARNI)
Medication that used for patient with reduced EF and HR>70 on maximally tolerated ß-blockers :
Ivabradine
Side effects of ACE-i / ARBs
🔸 Hypotension
🔸 HyperKalemia
🔸 Teratogenic
🔸 Cough & Angioedema (ACE-i)
Side effects of ARNI
Sacubitril/valsartan
🔸 Hpotension
🔸 HyperKalemia
🔸 Cough
🔸 Dizzness
Side effects of Ivabradine :
🔸 Luminous phenomena, visual brightness
🔸 Hypertension
🔸 Bradycardia
Side effects of Digoxin :
🔸 Blurry yellow vision
🔸 Arrhythmia / AVB / paroxismal atrial tachycardia
🔸 Cholinergic effect (N/V, diarrhea)
🔸 HyperKalemia
What is acute decompensated heart failure
Exacerbation of signs & symptoms of CHF
- Dyspnea
- Pulmonary edema
- Peripheral edema
- Ascites
What is the drug of choice for patient presenting with acute decompensated HF ?
IV diuretics
…
If not improved
BP <90/60 : add dobutamin
BP > 160/100 : add NG
A PDE-3 inhibitor used for short-term management of decompensated HF
Milrinone
CHF patient present with Hypotension
Consider […]
IVF
🫀» cardiogenic shock
Digoxin toxic level […]
> 2
Sensitive serologic test of CHF:
BNP > 100
Diabetic medication that lowers mortality in CHF […]
SGLT-2
