Acute and Chronic Heart Failure Revision

ejection fraction to determine HF

how much blood left ventricle can pump with each ejection

LVEF < 35 -40%

Chest Xray neumonic

A - alveolar oedema (consolidation e.g. pulmonary oedema)

B - kerly B lines - horizontal lines that appear on CXR, thin lines perpendicular to pleural surface

C - cardiomegaly - most usually due to hypertrophy of left ventricle

D - dilated upper lobe vessels

E - pleural effusions

DeNovo syndrome is acute hf without history of pre existing heart failure

pink frothy sputum in CHRONIC heart failure

BNP blood test first line for diagnosis of Chronic heart failure

NTBNP is an inactive fragment of bnp that is used for measuring purposes

Echocardiogram not enough to diagnose HF need to do BNP

loop diuretics used to treat acute hf END IN -IDE

HFrEF - reduced ejection fraction (main) 40% or less and HFpEF - preserved ejection fraction, greater than or equal to 50% LVEF

41-49% is mildly reduced ejection fraction

eplenerone used to treat CHRONIC heart failure not ACUTE

spironolactone causes gynocomastia

sodium glucose transporter 2 inhibitors - treatment of CHRONIC heart failure, end in -gliflozin

answer is 5

answer = 5, they are the four pillars of heart failure

4 Pillars of Heart failure medicine : ACEi and Beta blockers,(ARB instead of ACEi maybe), MRA, SLGT2 inhibitor

not lifestyle because his LVEF is very bad - sign of HF so would need to start treatment immediately, also has comorbidities that could cause HF

bisoprolol evidence backs use of prognostic, cardio selective

sacubitril + valsartan new chronic heart failure treatment

loop diuretics for QUALITY OF LIFE, TOO MUCH FLUID NOT PROGNOSIS

-IDE