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CHF - Coggle Diagram
CHF
Diagnostic Algorithm
History taking
Main complaint, side complaint, family history, previous illness, previous medicaitions?
Physical Examination
Viatl signs, weight, inspection palpation percussion and auscultation of lungs, heart; jugular vein pressure
Supporting Examination
Chest xray, EKG, lab work, biomarkers
Definition and Etiology of RHD
Rheumatic heart disease is a condition in which the heart valves have been permanently damaged by rheumatic fever. The heart valve damage may start shortly after untreated or under-treated streptococcal infection such as strep throat or scarlet fever.
Infection of Beta Hemolytic Streptococci
Risk Factors: genetic, lifestyle, previous illness, age, gender
Diagnostic Algorithm of RHD
History taking
Fever, swelling and pain of the joints, and eryhtema marginatum
Previous ilness
Family history
Lifestyle
Supporting examination
EKG, echocardiography, chest xray, cardiac MRI, and blood tests
Definition and Classification of Heart Failure
Definition
Heart failure is a complex clinical syndrome that results from a functional or structural heart disorder impairing ventricular filling or ejection of blood to the systemic circulation.
Classification
NYHA
Class I
Class II
Class III
Class IV
ESC
HFrEF
HFmrEF
HFpEF
According to the Function
Systolic function failure
Diastolic function failure
Etiology and Risk Factors
RIsk Factors
Age, family history, unhealthy lifestyle, infectious disease
Etiology
HFrEF
CAD, hypertension, valvular heart disease
HFmrEF
Primary hypertrophy, secondary hypertension, endocardial disease
Treatment and Primary Secondary Prevention of RHD
Treatment
Antibiotics, aspirin, antiinflammation, and surgery to repair or replace the damaged valve
Prevention
Primary prophylaxis is used to prevent acute rheumatic fever (RF) after identifiable episodes of infection with group A beta hemolytic streptococcus (GAS)
Secondary prophylaxis seeks to prevent progression of RHD after an episode of RF or in those with established clinical RHD.
Patophysiology of Heart Failure
Etiology or Risk Factors -> Systolic or Diastolic Failure -> Left Heart Failure -> Increased Pulmonary Pressure -> Right Heart Failure
Pathogenesis and Pathophysiology of RHD
Infection of Beta Hemolytic Streptococci --> antigen and antibody complex -->Inflammation; joints swelling, pain due to the accumulation of of immune complexes -> overexpression of CD 4 cells and burrowing inn the endothelial lining of valve heart.
Initial Treatment for CHF
ACEi, ARB, BB, DIGOXIN, and IVABRADINE
Heart Failure Complications
Pleural effusion, atrial fibrillation, hepatomegay, and bradyarrythmia
Clinical Manifestations
Shortness of breath, physical inactivity, orthopneu, dizziness, paroxysmal nocturnal dyspneu, oedema, palpitations, tachycardia, arrythmia.