13th OCT Teaching Nisha Talwar FY2. Chronic activation of RAAS and adrengic systems results in a...

13th OCT Teaching Nisha Talwar FY2

FAILURE

LEFT

RIGHT

Chronic activation of RAAS and adrengic systems results in a

vicious cycle that further exacerbates

physiological response

Causes

Left

IHD

Dilated cardimyopathy

Hypertension

Valve disease Mitral/aortic

Right

Chronic lung disease

PE

Pulmomary hypertension

Valve disease Triscupid/pulmonary

Congential heart disease ASD/VSD

Diagnosis

Need to do history and examination

Cardiac dysfunction must be demonstrated

Investigations Bloods CXR ECG ECHO

Need to treat underlying cause!!

Classifciation - NYHA

Typical CXR

Management

General

Medical

Non pharmacological

Management

Diurecti

cs

ACE inhibitors B- blockers

Aldosterone

antagonists

Intropes Nitrates

Non Pharmacological

Revascuarization CABG or angioplasty

Cardiac resynchronisation therapy Biventricaular pacemaker or ICD

Valve replacement

Cardiac Transplantation

LVAD (left ventricular assist device) and artificial heart

Home with a happy heart !