is a clinical syndrome of symptoms (breathlessness, fatigue) and signs (oedema, crepitations) resulting from structural and/ or functional abnormalities of cardiac function which lead to reduced cardiac output or high filling pressures at rest or with str
Often gradual onset in a patient with other coexisting cardiovascular disease (ischaemic heart disease, chronic kidney disease, DM, hypertension, respiratory disease)
3 of 12
a. what are the symptoms of heart failure
b. what causes these symptoms?
a.
• Fatigue (because not getting enough CO and oxygen delivered to tissues)
• Breathlessness on exertion and lying flat (because of pulmonary congestion)
• Peripheral oedema (leg oedema)
• Sometimes during night (lying flat (paroxysmal nocturnal dyspnoea
4 of 12
why does oedema accumulate in lungs and peripheries
because of pump failure
5 of 12
what are the heart failure diagnosis and investigation
- History and examination
- Blood tests (Incl B type natriuretic peptide (BNP) measurement) Hormone secreted by heart. V high in heart disease
- Echocardiography
- ECG
6 of 12
what is the treatment of heart failure ?
a. Address underlying cause and symptoms (such as IHD[lifestyle, beta blockers, aspirin], hypertension [blood pressure control], VHD [valve replacement], arrhythmias, alcohol excess and numerous other rare causes).
b. implanted devices
c. surgery (If c
7 of 12
what devices can be implanted in patients with heart failure ?
- implantable cardioverter defibrillator
- Cardiac resynchronization therapy (pacemaker with or without defibrillator)
what meds are given for HF- reduced ejection fraction
diuretics, ACE inhibitors or Angiotensin II receptor antagonist, beta blockers, digoxin, aldosterone antagonist, devices, depaglifozin, sacubitrol/valsartan
10 of 12
what are the dental. aspect if someone has heart failure
avoid treating if unstable symptoms, caution when lying patient flat, postural hypotension is common due to meds , avoid NSAIDS (cause fluid retention), do they have pacemaker, ICD or CRT and check safety with dental equipment.
polypharmacy (drug side eff
11 of 12
what to do for acute heart failure if presenting in dental surgery
ABCDE approach, potential cardiac arrest and use AED
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