200 likes | 694 Views
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).
E N D
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) • 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.
Pathophysiology • Definition • Left and right heart failure • Causes
Causes • Alcoholic cardiomyopathy • Infective • Cancer treatment • Coronary heart disease • Hypertension • Anaemia • Hyperthyroidism • Atrial fibrillation • Congenital • Valvular heart disease
History • What symptoms? • How would you ask the patient?
Examination • What signs may be present?
Investigations • Bedside tests • Bloods • Imaging • Special tests
CXR findings • A- alveolar oedema • B- KerleyB lines • C- cardiomegaly • D- diversion to the upper lobes • E- pleural effusion (bilateral)/pulmonary oedema
Management- chronic • Conservative • Medical • Surgical
Management- acute • ABC • Sit up • Furosemide • GTN infusion
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.
Questions • Differential diagnosis • Heart failure • COPD • Lung cancer • Angina • PE • Explain cardiac rehabilitation
As an F1……. • Most important thing is initial management in A and E and flash pulmonary oedema • AKI vs Pulmonary oedema always a problem