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Flashcards in CHF Deck (5)
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What is heart failure?

progressive syndrome characterized by structural and/or functional abnormalities in cardiac contraction, adverse neuro-hormonal adaptations and remodeling and co-morbidities that collectively alter myocardial function, fluid regulation, respiration, and perfusion, and overall hemodynamic stability.


What are the AHA heart failure stage? What is recommended tx for each stage.

Stage A: high risk; HTN, coronary artery dz, DM, FHx cardiomyopathy
--Tx: treat htn and lipids, smoking cessation, exercise, limit alcohol, ACEi

Stage: B: asymptomatic; previous MI, LV systolic dysfunction, asymptomatic valvular dz. (Structural changes)
--Tx: PLUS ACEi, beta blockers

Stage C: symptomatic HF: known structural heart dz, SOB and fatigue, reduced exercise tolerance. (Now they feel effects of structural change.)
--Tx: PLUS ACEi, beta blockers, diuretics, digoxin, aldosterone receptor antagonists, dietary salt restriction

Stage D: Refractory end-stage heart failure; marked sx at rest despite maximal medical therapy (failing therapy)
--Tx: PLUS inotropes, transplant, VAD

**Can only move in one direction


What are the NY Heart associated classifications of heart failure?

Class I: minimal (ordinary physical activity doesnt cause undue sxx; no limitations)

ClassII: Mild (Ordinary activity causes sx, no strenous exercise)

ClassIII: Moderate (less than ordinary activity causes sx; activity limited to ADLS)

Class IV: severe (Sx with any physical activity)

*You can move back and forth between these functional classes)


How can we easily assess cardiovascular status?

Determine whether the patient is wet or dry; assessing fluid status and congestion

Determine whether patient is warm or cold by assessing indicators of perfusion


management of heart failure

Stabalize the patient: give diuretic (torsemide & bumetanide is more bioavailable than lasix)

Stabilize the dz:
-ace inhibitor + beta blocker

Treat residual sx: digoxin