Define heart failure.
Heart failure is a condition of impaired cardiac function due to structual or functional disorder that decreases the ability of the ventricles to fill and eject. Therefore the heart cannot pump blood at a volume required to meet the bodies demand.
Decribe the pathophysiology of heart failure.
- myocardial muscle loss
- changes to surviving myocardial muscle cells
- muscle hypertrophy
- ejection function decreases and ventricles dilate in order to maintain stroke volume
Name FIVE differing clinical manifestations of both left and right heart failure.
Example: Both left and right experience fatigue, so therefore this is a common clinical manifestation. Left HF experiences dyspnoea, whilst right HF experiences oedema, so these are differing conditions.
Left heart failure
- dyspnoea
- orthopnoea
- dry, hacking cough
- crackles; pulmonary oedema
- nocturia
- tachycardia
- chest pain
Right heart failure
- oedema
- weight gain
- nausea
- anorexia
- GI bloating
- ascites
- tachycardia
- distended jugular veins
- behavioural changes
What is pulomonary oedema?
In your own time, look up the pathophysiology.
An abnormal accumulation of fluid in the interstitial tissue and alveoli of the lung.
Name the TWO drug families in the 1st line treatment of chronic heart failure, and name at least ONE drug in each family.
ACE inhibitors
- enalopril
- captopril
- ramipril
Angiotensin II receptor blockers
- irbesartan
Name the THREE drug families in the 2nd line treatment of chronic heart failure, and name at least ONE drug in each family.
Diuretics
- frusemide (loop diuretic)
Beta-blocker
- bisoprolol
- carvedolol
- metoprolol
Inotropic
- digoxin
- adrenaline
- dobutamine
If there is an excess in fluid volume, what are the THREE types of diuretics that could be used?
Thiazides
- hydrocholrothiazide
Loop diuretics
- frusemide
Potassium sparing
- spironolactone
Name THREE indications for a CABG.
- unstable angina refractory to medication or percutaneous coronary intervention (PCI)
- left main coronary artery disease
- multi vessel disease
- treatment of MI or heart failure
- complications from PCI
- failed PCI
Name FIVE complications associated with CABGs.
- bleeding
- cardiac tamponade
- arrhythmias
- blood pressure alterations
- electrolyte and metabolic disturbances
- atelectasis
- pleural effusion
- pain
- neurological must be monitored
