Optimizing Heart Failure Management

This episode covers Chapter 81 of Rosen’s Emergency Medicine. This one is mint! Heart failure is one of those must-know-about presentations, you WILL see this in the ED.

1. Define
   1. Cardiac index
   2. Preload
   3. Afterload
2. Describe:
   1. How compliance changes the relationship between end diastolic pressures and volume
   2. the Frank-Starling relationship
   3. Pousseils Law and LaPlaces Law
3. List 3 CV and 4 Neurohormonal physiologic compensatory mechanisms in CHF
4. List the 5 most common disease processes resulting in HF and briefly describe the contribution of each
5. Describe the different classifications of heart failure:
   1. Acute vs. Chronic HF
   2. Systolic vs. Diastolic dysfunction
   3. Right vs. Left sided HF
   4. High-output vs. Low-output HF
6. Describe the NYHA function HF Classes and the Killip Classification
7. List 10 common precipitants of acute HF
8. List 6 historical predictors of acute HF and 6 clinical features of acute HF
9. List 5 CXR and 5 ECG findings of HF
10. What is the role of BNP in HF?
11. Describe the primary management goals in acute HF
12. Describe the mechanism of action of NIPPV in HF. Who needs to be intubated? When is it contraindicated?
13. Describe the pharmacologic treatment strategy for:
    1. Acute pulmonary edema + adequate perfusion
    2. Acute pulmonary edema + hypotension
14. How do nitrates work in acute pulmonary edema? What is the dose?
15. List 10 treatment options for chronic HF