HeartFailure_by_dr_tayyaba_fatima_slmc.pptx

Acute and long term management.

1. Heart Failure Dr. Tayyaba Fatima
House Officer Cardiology

2. Definition It is a clinical syndrome characterized by decreased myocardial performance leading to over activation of neuro-endocrine system, hypo perfusion of peripheral system, systemic and pulmonary congestion.

3. Pathophysiology

4. Systolic VS Diastolic Systolic: inability of ventricles to contract Resulting in dec. Cardiac output ( IHD, MI, cardiomyopathies) EF <40% Diastolic: inability of ventricles to relax fully to allow filling Normally causing filling pressure. ( Constrictive Pericarditis, restrictive cardiomyopathy, Cardiac temponade) EF>50%

5. Left vs right sided Clinically left sided is more symptomatic while right sided shows more signs

6. Aggravating Factors Major Ischemia Infection Arrhythmias Minor: Poor/non compliance with medication Poor dietry management Uncontrolled hypertension Pulmonary embolism

7. Complications Renal Failure Liver hypoperfusion Hypokalemia Hyperkalemia

8. Investigations CXR ECG Echocardiography RFTs Serum Electroytes BNP (>500 pg /ml)

9. Management Symptomatic relief Diurestics Nebulization Propup position Beta blockers if CI then Ivabredine if CI then Digoxin ARNIs/ ACEi /ARBs if CI then Hydralazine/ Nitrates MRAs ( spiromide ) SGLT2 inhibitors ( Empagloflozin )

10. Cntd . Patient education HTN, DM management Lifestyle modification Salt and water restriction Encourage exercise if tolerable