heart failure types and drugs

what is ejection fracture

measures how well the left ventricle is filling, normal is 55-70%

what is stroke volume

amount of blood pumped by left ventricle, 60-100mL per beat

what is cardiac output

the amount of blood the heart pumps per minute, 5-6L per min

what is SVR

systemic vascular resistance, the resistance to blood flow in the body, determines bp

SVR level in septic shock

low

cardiac output formula

SV x HR

systolic heart failure (HFrEF)

inadequate pumping of blood and decreased contractility

caused of HFrEF

CAD, cardiomyopathy, HTN, diabetes

what is high output failure caused by

caused by increased metabolic needs, septicemia, anemia

diastolic HF (HFpEF)

problem with relaxation, stiff heart, causes ineffective filling

what is diastolic HF caused by

usually HTN, also increased hafterload, decreased cardiac output/stroke volume

trmt of HFpEF

SGLT2 has been shown to reduce hospitalization

left side HF

left side cannot pump blood efficiently

caused of left side HF

HTN, coronary artery and valve disease, myocardium diseases

s/sx of left side HF

dyspnea, orthopnea, acute pulmonary edema, pink frothy sputum, cough crackles

right side HF

right side of the heart cannot pump enough blood, also called cor pulmonate

right side HF causes

left side hf, right ventricular MI, COPD, any problem with the lungs

right side HF s/sx

fatigue, enlarged liver/spleen, weight gain, JVD, cardiomegaly, ascites, anorexia/nausea

acute heart failure

MI, mitral or aortic regurgitation

how do we diagnose acute heart failure with EF

at least 50%

acute heart failure chest x ray

enlarged heart

goal for trmt of acute heart failure

optimizing heart function and tissue perfusion, ACE/ARB/ARNI, no salt, fluid restriction, weight loss

clinical impairment of heart failure, 1-4

1: no limitation of physical activity, 2: slight limitation of physical activity, 3: marked limitation, comfy at rest, 4: s/sx present at rest

ACE MOA and trmt

for HFrEF, blocks RAAS, -pril

ARB MOA and trmt

for HFrEF, blocks the hormone that breaks down BNP

SGLT2i MOA

inhibits the reabsorption of glucose in the kidneys, used for fluid overload in HF

beta blockers

decrease in B1, decreases hr, contractility and O2 demand, can be selective or non selective

Aldosterone antagonists

k sparing diuretics, decrease preload

what is furosemide

diuretic

cardiac glycosides MOA and most common example

digoxin, increases contractile force and decreases heart rate

Ivabradine

works on If channels of the heart, used when beta blockers are ineffective or maximized, only effects heart rate and reduces work load of the heart

If channels

main generator od diastole depolarization in SA node cells