HEART FAILURE A A PUMP IN DISTRESS Dr
- Slides: 30
HEART FAILURE: A A PUMP IN DISTRESS Dr Tom Mabin Vergelegen Mediclinic Somerset West Cardiac Support group September 2016
“ die hart is net ‘n pomp” 1968
Causes of heart failure § § § § § Poorly controlled hypertension(high blood pressure) Myocardial infarctions(heart attacks) Uncontrolled Irregular heart rhythms(arrhythmias) Leaking heart valves Blocked heart valves Infections. . viral toxins: /medications eg alcohol/chemotherapy Congenital Unknown(cardiomyopathy)
Heart failure: the size of the problem § § § >10% of patients >70 years have HF Commonest cause of hospitalisation in >70 years Increasing frequency: ageing population; more survivors of myocardial infarction Most have high BP and /or heart attack history Diagnosis often missed: treatment delayed
Symptoms of heart failure § § § Fatigue/tiredness/lack of energy Shortness of breath Inability to lie flat in bed at night(orthopnea) Swelling of legs/abdomen Blue extremities
Diagnosis of heart failure History § History… CAUSES: § ü ü ü ü High blood pressure Heart attacks/angina Heart murmurs / valves Heart surgery Flu-like illnesses Toxins/chemotherapy CLINICAL EXAMINATION……….
Examination in heart failure § § § Breathless Fast pulse BP § § § fluid accumulation Neck veins elevated Ankle swelling (oedema) Lung congestion(crackles) Murmurs Abdominal swelling
Diagnosis of heart failure § ECG ü ü ü § Arrythmia Heart attacks Heart enlargement Echocardiogram Heart size Heart function. . left ventricular performance (ejection fraction) ü Valve leaks and/or blockages ü ü § Angiogram ü Coronary artery disease/ heart attckes
chambers and valves Ultrasound or sonar
Management of heart failure § LIFESTYLE CHANGES: Restrict fluid intake: 1. 5 Li/day: daily weighing ü Reduce salt intake ü Quit alcohol / cigarettes ü Reduce weight ü Regular moderate excercise ü
§ Management of heart failure Treat the cause: üHigh BP üCoronary disease: Stents/bypass üArrhythmia üAttend to the valve lesion if appropriate eg surgery
Management of heart failure § Treat the symptoms Diuretics: remove the water § Ace inhibitors: assist the heart § Beta-blockers: assist the heart; slow the pulse § Specialised medications §
The Donkey Analogy Heart failure limits a patient's ability to perform the routine activities of daily living…
Diuretics Reduce the number of sacks on the wagon eg: lasix: puresis: spiractin
ACE inhibitors Reduce the number of sacks on the wagon eg: prexum; pearinda; zartan;
ß-Blockers Limit the donkey’s speed, thus saving energy Dilatrend; Carloc; Bilocor
Take your pills!
Management of heart failure § Specialised devices üPacemakers üArtificial mechanical hearts üHeart transplant
� Postero-lateral
LVAD: artificial heart
Pacemakers(CRT) and mechanical heart(LVAD) Increase the donkey’s (heart) efficiency
“ die hart is net ‘n pomp” 1968……. . 2016
- Failure to capture vs failure to sense ecg
- Pacer failure to sense
- Ductile break
- Centrifugal pump failure modes
- Water pump failure causes
- Internal gear pump advantages and disadvantages
- Diagram of reciprocating pump
- External and internal gear pump
- Chapter 24 heart failure drugs
- Heart failure complications
- Compensatory mechanisms of heart failure
- Keith rn heart failure case study
- Causes of cardiomegaly in child
- Heart failure forward vs backward
- Heart failure
- Heart sound landmarks
- Forrester classification
- Donkey analogy heart failure
- Edema assessment
- Vetsulin dosage chart for dogs
- Congestive heart failure zones for management
- Classification of ejection fraction
- Acute vs chronic heart failure
- Cor pulmonale
- Nursing assessment for congestive heart failure
- Diabetes and heart failure
- Lmnop heart failure
- Heart failure definition
- Dr nienkemper
- Acute pulmonary congestion histology
- Dromotropicity