What is the definition of heart failure?
Heart cannot pump blood effectively.
Heart failure can be characterized by two types: HFrEF and HFpEF.
What is HFrEF and its ejection fraction range?
HFrEF: EF <40% (systolic dysfunction).
HFrEF stands for Heart Failure with reduced Ejection Fraction.
What is HFpEF and its ejection fraction range?
HFpEF: EF ≥50% (diastolic stiffness).
HFpEF stands for Heart Failure with preserved Ejection Fraction.
What are common causes of heart failure?
- Hypertension
- Ischemic heart disease
- Valvular disease
- Arrhythmias
- Cardiomyopathy
These conditions can lead to the development of heart failure.
List some symptoms of heart failure.
- Dyspnea
- Orthopnea
- Edema
- Fatigue
- Weight gain
- Nocturia
- Cough
Symptoms can vary in severity and may affect daily activities.
What is the recommended sodium restriction for heart failure management?
Sodium restriction <2 g/day.
This helps manage fluid retention in heart failure patients.
What are some non-drug management strategies for heart failure?
- Fluid restriction if severe
- Daily weights
- Exercise as tolerated
- Vaccinations: influenza, pneumococcal
- Avoid NSAIDs, alcohol excess, smoking
Non-drug management is crucial for overall heart failure management.
What are the first-line medications for HFrEF known as the 4 Pillars?
- ACE inhibitors
- ARBs
- ARNI
- Beta-blockers
These medications are essential in the treatment of heart failure with reduced ejection fraction.
What are ACE inhibitors and name two examples.
ACE inhibitors: ramipril, perindopril.
They reduce mortality and hospitalization in heart failure.
What are common side effects of ACE inhibitors?
- Cough
- Hyperkalemia
- Angioedema
- Renal dysfunction
These side effects necessitate monitoring during treatment.
What are the contraindications for ACE inhibitors?
- Pregnancy
- Renal artery stenosis
- Angioedema history
These conditions may increase the risk of adverse effects.
What are ARBs and when are they used?
ARBs (valsartan, candesartan): use if ACEi intolerant.
ARBs are an alternative for patients who cannot tolerate ACE inhibitors.
What is ARNI and its advantage over ACEi?
ARNI (sacubitril/valsartan): better than ACEi alone.
ARNI combines two medications to improve heart failure outcomes.
What must be done before starting ARNI?
Must stop ACEi 36h before starting.
This is important to avoid the risk of angioedema.
What are common side effects of ARNI?
- Hypotension
- Hyperkalemia
- Renal impairment
These side effects require careful monitoring.
What are the contraindications for ARNI?
- Angioedema history
- Pregnancy
- ACEi use
Similar to ACE inhibitors, certain conditions can increase risks.
What are beta-blockers and name three examples.
Beta-blockers: carvedilol, bisoprolol, metoprolol SR.
These medications help improve ejection fraction and reduce mortality.
