Diagnostics
What type of test would show the ejection fraction of the heart?
Echocardiogram
What is an example of Orthopnea in Mr. Smiths History?
SOB worsen's when he lies flat
What is Orthopnea?
SOB when lying flat
What is an example of and Ace-Inhibitor?
Ramipril
What symptoms indicate Right sided HF?
Pedal Edema
What lab value may not be ordered as a baseline for CHF, but would confirm it if suspected?
BNP
What other co-morbidities may exacerbate Mr. Smiths CHF?
Smoker, CAD, HTN, CKD, DM, COPD
Would someone with CHF have an increased troponin?
Yes! The exact mechanism is unclear, but it is suspected that the left ventricular dysfunction in HF can cause a release of Troponin from the cardiomyocite stretch.
Would you start fluid on a patient with CHF?
No, it may increase the overload. But re-evaluate once Diuretics have been given to ensure the kidney is perfused.
What came first CHF or CKD?
They exacerbate eachother
What test shows the outline of the heart silhouette?
Chest Xray
What might hinder Mr. Smith's compliance with medication and lifestyle changes?
Dementia, age, family doing his primary care
What disease processes may contribute to the elevation in CRP?
COPD, CKD
What is the best diuretic for CHF?
Lasix
Why may you see hypokalemia in patients with CHF?
diuretics can increase the loss of potassium