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Chronic Heart Failure (Ix (CXR: ABCDEF (Alveolar shadowing, Kerley B lines…
Chronic Heart Failure
Ix
Bloods
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NT-proBNP
Secreted from ventricles in response to ↑ stretch and ↑HR
↑ levels is most accurate diagnostic indicator of HF
NICE recommends that heart failure is not Dx w/o ↑ BNP
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Mx
General
MDT: GP, cardiologist, physio, dietician, specialist nurses
Optimise CV risk: statins, anti-HTN, DM, anti-plat
Monitor: regular f/up and echo
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Trials Showing Drug Benefit in Heart Failure
ACEi: Consensus 1
ARB = ACEi: ELITE-2
β-B: CIBIS-2, MERIT-2
Spironolactone: RALES
Left
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Symptoms
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Nocturnal cough (± pink, frothy sputum)
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New York Classification
- No breathlessness
- Breathless w/ moderate exertion
- Breathless w/ mild exertion
- Breathless at rest