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Medicine Notes Cardiology Notes

Heart Failure Notes

Updated Heart Failure Notes

Cardiology Notes

Cardiology

Approximately 27 pages

Complete set of notes on Cardiology. COvering all the main conditions with pathophysiology, presenting symptoms, investigation and management. Includes relevant pharmacology. Clear headings and concise bullet points, including table summaries. ...

The following is a more accessible plain text extract of the PDF sample above, taken from our Cardiology Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

Heart Failure

Failure of the heart to maintain an adequate perfusion of the tissues despite adequate filling pressure

Aetiology

Causes of LHF

  • Inadequate LV filling

    • Mitral stenosis

  • Pressure overload

    • Aortic stenosis

    • Hypertension

  • Volume overload

    • Aortic/mitral regurg.

    • High output HF

  • LV muscle disease

    • MI

    • Cardiomyopathy

Pathogenesis

  • Causes listed above lead to one or more of;

    • Myocyte loss

    • Increased afterload (pressure against which heart has to pump)

    • Volume overload

Heart responds to this ventricular remodeling = myocardial hypertrophy + ventricular dilation

Initially process is adaptive as it decreases wall stress and maintains cardiac output

Eventually

Decreased ventricular systolic function

Decreased CO

RAS activation

Salt and water retention

Increase in vasoconstrictors

Further damage

Classification

Systolic vs diastolic HF

  • Systolic = impaired contractility of myocardium

  • Diastolic = impaired relaxation of myocardium

LHF vs RHF

  • Left = symptoms of pulm. Vascular congestion e.g dyspnea, pulm. Oedema

  • Right = Symptoms of systemic vascular congestion e.g ascites, raised JVP

Low output vs High output

  • Low = inadequate output for tissue perfusion

  • High = output fails to meet increased needs (thyrotoxicosis, anaemia)

Clinical features

Left Heart Failure

Symptoms Signs

Dyspnoea

Orthopnea

Paroxysmal nocturnal dyspneoa (PND)

Nocturnal cough

Cold peripheries

Nocturia

Fatigue

Mild

  • Bibasal creps

Severe

  • Cyanosis

  • Pink frothy sputum

  • Extensive creps

  • Tachycardia

  • Gallop rhythm (3rd heart sound)

Right Heart Failure

Symptoms Signs

Ankle swelling

Ascites

Nausea (gut oedema)

Anorexia

Epistaxis

Pulsation in neck and face

Raised JVP

Hepatomegaly

Ascites

Ankle oedema

Skeletal muscle wasting

NYHA classification of...

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