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Heart Failure

Heart Failure. Chloe Hymers and Morag Sime. Aim. Know the difference between left and right heart failure Be able to take a history specific to heart failure Understand how to investigate heart failure Know how to manage acute heart failure. Objectives (from your syllabus).

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Heart Failure

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  1. Heart Failure Chloe Hymers and Morag Sime

  2. Aim • Know the difference between left and right heart failure • Be able to take a history specific to heart failure • Understand how to investigate heart failure • Know how to manage acute heart failure

  3. Objectives (from your syllabus) • Recognise left and right heart failure from the history and physical examination and relate them to underlying pathophysiological changes. • Recognise the role of radiography, ECG and echo in the diagnosis of heart failure • Initiate management of patients with heart failure by the appropriate use of diuretics, vasodilators and inotropes and monitor the response.

  4. Pathophysiology • Definition • Left and right heart failure • Causes

  5. Causes • Alcoholic cardiomyopathy • Infective • Cancer treatment • Coronary heart disease • Hypertension • Anaemia • Hyperthyroidism • Atrial fibrillation • Congenital • Valvular heart disease

  6. History • What symptoms? • How would you ask the patient?

  7. Examination • What signs may be present?

  8. Investigations • Bedside tests • Bloods • Imaging • Special tests

  9. CXR findings • A- alveolar oedema • B- KerleyB lines • C- cardiomegaly • D- diversion to the upper lobes • E- pleural effusion (bilateral)/pulmonary oedema

  10. A

  11. B

  12. C

  13. D

  14. E

  15. Management- chronic • Conservative • Medical • Surgical

  16. Management- acute • ABC • Sit up • Furosemide • GTN infusion

  17. Case study • 61 year old man 3 month history of malaise, SOB and ankle swelling. Short of breath walking up stairs. PMH- hypertension, MI, smoked 40 cigarettes for 40 years.

  18. Questions • Differential diagnosis • Heart failure • COPD • Lung cancer • Angina • PE • Explain cardiac rehabilitation

  19. As an F1……. • Most important thing is initial management in A and E and flash pulmonary oedema • AKI vs Pulmonary oedema always a problem

  20. Questions

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