notes heartfailure
DESCRIPTION
gTRANSCRIPT
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OSCE-Aid Presents:
Common Cases:
Heart Failure
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Key Cardiology cases:
1) Valvular Heart Disease
2) Heart Failure
3) Pacemakers
4) CABG scar
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Heart Failure - signs:
Peripheral:
SOB
Cyanosis
Cool peripheries
Pitting oedema (R)
Ascites (R)
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Heart Failure - signs:
Precordium:
S3
Bibasal creps
Wheeze
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Present your findings:
Heart Failure:
Today I examined the cardiovascular system of Mr X. He was short of breath at rest. There was evidence of pitting oedema and his
peripheries were cool to the touch. On auscultation were bibasal
crepatations.
These findings are consistent with heart failure.
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Top questions: (1)
What is heart failure?
Cardiac output insufficient to meet the body's
metabolic requirements despite adequate filling
pressures
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Top questions: (2)
What causes of heart failure do you know?
Left:
IHD
Left sided valvular heart disease
HTN
Right
LVF
Cor pulmonale
Right sided valvular heart disease
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Top questions: (3)
How would you like to investigate this patient?
Full Hx with a particular interest in highlighting any symptoms such as:
Fatigue
Dyspnoea
Orthopnoea + PND
Cough (+/- pink frothy sputum)
Weight loss
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Top questions: (3)
How would you like to investigate this patient?
Bloods - BNP
ECG
Ischaemia
Hypertrophy
AF
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Top questions: (3)
How would you like to investigate this patient?
CXR ABCDEF
Alveolar shadowing
Kerley B lines
Cardiomegaly (>50% cardiothoracic ratio)
Upper lobe Diversion
Effusions
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Top questions: (3)
How would you like to investigate this patient?
Echo
Systolic and diastolic dysfunction
Ejection fraction
Normal = 55-70%
Hypertrophy
Valve lesions
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Top questions: (4)
How would you like to manage a patient with heart
failure?
Management HF can be divided into conservative, medical and surgical options.
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Management Heart Failure
Conservative
Regular follow- up / Exercise/ smoking cessation etc
Medical
ACEi + B-Blocker
Loop diuretic
Spirinolactone
Digoxin
Optimise cardiovascular risk factors: HTN / DM / Hypercholesterolaemia
Surgical
Left Ventricular Assist Device / Heart transplantation
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Written by: Oliver Butters
Edited by: Jayne Ellis
Hosted by: OSCE-Aid
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