CJ @cathyjostrand on GrepMed

$Congestive Heart Failure - Causes, Pathophysiology and Differential Diagnosis • Dilated Cardiomyopathy • Hypertrophic Cardiomyopathy$

Congestive Heart Failure - Causes, Pathophysiology and Differential Diagnosis • Dilated Cardiomyopathy • Hypertrophic Cardiomyopathy • Restrictive Cardiomyopathy HFrEF Causes: • Cardiovascular • Toxic • Infectious • Other HFpEF Causes: • Afterload • Valvular • Infiltrative • Genetic • Other Dr. Jorge Cortés @Jcortesizaguirr #Congestive #HeartFailure #Causes #Pathophysiology #Differential #Diagnosis #cardiology #HFrEF #HFpEF #CHF

Decompensated Heart Failure Classification Wet (volume overloaded) vs Dry (euvolemic) and Cold (low cardiac output) vs Warm (normal cardiac output) - Dr. Eric Strong @DrEricStrong - Strong Medicine https://www.youtube.com/c/EricsMedicalLectures/ #Decompensated #HeartFailure #Classification #CHF #diagnosis #cardiology

Decompensated Heart Failure Management Strategies Wet (volume overloaded) vs Dry (euvolemic) and Cold (low cardiac output) vs Warm (normal cardiac output) - Dr. Eric Strong @DrEricStrong - Strong Medicine https://www.youtube.com/c/EricsMedicalLectures/ #Decompensated #HeartFailure #management #CHF #cardiology

Severe Heart Failure & Cardiogenic Shock - Management Checklist Evaluation - EKG & echocardiography - CBC, Lytes including Ca/Mg/Phos - Troponin, Lactate, Liver function tests if shock is suspected - TSH and/or digoxin level depending on context Rx 1 — Treat the lungs - Consider BiPAP (vS intubation) in cardiogenic pulmonary edema - Large effusion(s) may be drained if causing acute distress - Consider inhaled epoprostenol for intubated patient with right ventricular failure or pulmonary hypertension Rx 2 — Optimize the MAP - HTN/normotension Afterload reduction (nitroglycerine infusion or hydralazine 37.5 mg & isosorbide dinitrate 20 mg q6hr) - Hypotension (severe or w/ organ dysfunction) Norepinephrine (epinephrine is another option in HFrEF with hypoperfusion) Rx 3 — Optimize the volume - Fluid challenge if: hypoperfusion, no pulmonary congestion (no B-lines on ultrasound), assessment suggests total body hypovolemia - Diuresis if: significant systemic/pulmonary congestion, assessment suggests total body volume overload Rx 4 — Consider inotrope (usually dobutamine/milrinone) for HFrEF if: - (a) Normotensive patient with organ hypoperfusion - (b) Refractory cardiogenic pulmonary edema in hypotensive patient - Note: Digoxin may be considered a weak inotropic agent in patients With chronic AF, HFrEF, and refractory heart failure. Rx 5 — Treat underlying etiology - New-onset tachyarrhythmia causing heart failure: cardioversion, antiarrhythmics - Ischemic cardiomyopathy: Revascularization, treatment for acute MI if present Rx 6 — Mechanical circulatory support - Consider for persistent Organ failure — device Of choice is patient/institution specific. Rx 7 — Things to avoid - Nephrotoxins (e.g. NSAlDs, ACE-inhibitors, angiotensin receptor blockers) - Initiation of beta-blocker in decompensated heart failure - Any beta-blocker or calcium channel blocker (eg diltiazem) in a patient with cardiogenic shock #Checklist #CHF #Shock #Cardiogenic #HeartFailure #Cardiology #Management

Symptoms and Sign of Congestive Heart Failure. #Congestive #HeartFailure #CHF #Signs #Symptoms #PhysicalExam ** GrepMed Recommended Text: Bates' Guide to Physical Examination and History Taking - https://amzn.to/2Z6LYmf

Right Sided Heart Failure Mnemonic: "AW HEAD" ANOREXIA & NAUSEA WEIGHT GAIN HEPATOMEGALY EDEMA (BIPEDAL) ASCITES DISTENDED NECK VEIN #Mnemonic #AWHEAD #RightSided #HeartFailure #Cardiology

The distinctive phenotypes of Acute Decompensated Heart Failure (ADHF), their presentations, and suggested therapeutic routes #Phenotypes #HeartFailure #Decompensated #CHF #Diagnosis #Management #Presentations

Medications Used in Congestive Heart Failure In CHF, the heart is failing as a pump; cardiac output is therefore insuffcient to meet the metabolic demand for oxygen in the body. CHF also causes congestion the lungs and venous circulation. Compensatory mechanisms, such as the activation of the sympathetic system and the renin-angiotensin system are designed to increase cardiac output on a short-term basis but eventually place further strain on the heart if the heart failure is chronic Drug therapy in chronic CHF aims to inhibit these unhelpful compensatory mechanisms. #Pharmacology #CHF #Medications #Action #Congestive #HeartFailure #Cardiology #Preload #Afterload

Pathogenesis of Edema in Heart Failure (Cardiac Edema) #Edema #CHF #HeartFailure #Pathophysiology

In order to better classify heart failure, the American College of Cardiology Foundation and the American Heart Association in 2001 published a four-component staging of heart failure in which progression occurs in only one direction using risk factors as a classification model. The previous New York Heart Association functional class, based solely on symptoms, can still describe the current functional status of a patient in Stages B through D of the ACC/AHA Classification. But now the ACC/AHA classification allows for categorization of patients as their status changes by improving or becoming worse, especially in Stage C. Below one can see how these two classification methods crossover and classify a patient. With treatment, a heart failure patient can become asymptomatic, but will remain Stage C. Stage B is defined as development of structural heart disease in patients who never show symptoms or signs of heart failure. Most patients with a diagnosis of heart failure with either past or current symptoms are considered Stage C. Approximately 1% of patients with heart failure have progressed to an advanced Stage D. #Diagnosis #Cardiology #CHF #Congestive #HeartFailure #Staging #Classification #Stages #Classes #NYHA #ACCAHA