HEART FAILURE Heart Failure is a clinical diagnosis, supported by investigations such as blood tests and echo. Echo is an ultrasound of the heart which looks at function of the heart pump. This can differentiate heart failure into preserved or reduced ejection fraction (EF) NYHA scoring assesses symptoms and therefore function but is dynamic - it will change with treatment and with progression. | -No physical limitation of activity ll - Breathless on exertion e.g. incline lll - Breathless on minimal exertion e.g. flat IV - Breathless at rest Treatments can be divided into Symptomatic e.g, Diuretics Disease Modifying e.g. ACE-inbhibitors, beta-blockers, aldosterone blockers Sesnnad uth CanSeannert Heart fatluie Bforeemat = 58 y[o° 5 estall = [2-6 beak ) HEIGHT : 5 ft 14 tochy(BWime2ie WEIGHT, 73 K CHieF COMPING: SOB BEFORE ADM. : Onset oh Ayspnenfl On thopnen, Ankle edema, Paxosyf AUERGYs NO mal nocturnal dyspnea ,Nocwia DIETARY PRESCRIP TON s No 2-3 kines vigtt) mild deperdens E\WSs Distenbech CARDIRNE EE a Cow OF MAK. IMPULSE: 6 ker costal Spore + Hapate adalat rafbun + 3) pitting edema + Sacral edema S CHEST XRAY; Snspictatery ols Rhonch: bill —- LAB VALVES ol Problem PROBLEMS + Histon of feaat bun, (0 you. history of Stee asthritis , Depression, HTNSesnnad uth CanSeannermotel ere TLL] a Sy Signs and Symptoms ened) ee cone ort of brea r » 0 oughing vic Wi N Is Dizziness Swollen ankles (@.) | 4 Cel bloating Loss of appetite ) & Sleep disturbance» hortness of breath during exertion » Upright respiration position » Shortness of breath and coughing at night “-4 © Palpitations » Fatigue and tiredness appetite « Lower leg edema + Weight gain Seanned uth ComseonnerSesnnad uth CanSeannerCongestive Heart Failure Stages and Classes ACC/ AHA Stage A. At risk for heart disease but no actual structural disease B. Structural disease but no prior or current symptoms of heart failure C. Structural disease with past or current symptoms of heart failure D. End-stage disease (does not respond satisfactory to treatment) NYHA Functional Class II. Slight limitation of physical activity in the form of moderate exertion III. Marked limitation of physical activity in the form of minimal exertion IV. Inability to exert because of symptoms of heart failure at rest ACC = American College of Cardiology; AMA = American Heart Association; NYHA = New York Heart AssociationSesnnad uth CanSeannerSesnnad uth CanSeannerSesnnad uth CanSeannerSesnnad uth CanSeanner