BUMC Basics.pdf - Anesthesia Home
BUMC Basics.pdf - Anesthesia Home
BUMC Basics.pdf - Anesthesia Home
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41<br />
Therapy — Therapy is guided by stage of heart failure. For<br />
acute HF relief refer to pulmonary edema section.<br />
Stage Characteristics Therapy<br />
A No symptoms, no<br />
structural<br />
disease, just risk<br />
factors. (CAD,<br />
DM, HTN,<br />
cardiotoxic<br />
exposures)<br />
B Abnl. LVF,<br />
structural heart<br />
disease, previous<br />
MI, but<br />
asymptomatic.<br />
C Structural heart<br />
disease and<br />
symptomatic HF.<br />
Life style<br />
modifications, treat<br />
HTN, treat HLD, and<br />
control DM.<br />
ACEI: if HTN, DM, &<br />
PVD are present.<br />
All of stage A therapy,<br />
plus ACEI and beta<br />
blocker<br />
All stage’s A&B, plus<br />
diuretics, Na+ restrict,<br />
aldactone, AICD, BiV<br />
pacing,<br />
nitrates/hydralazine,<br />
and digoxin<br />
D Refractory HF All stages A,B, & C,<br />
plus LVAD, heart<br />
transplant, IV<br />
ionotropes, and<br />
hospice<br />
In the chart if you state that a person has heart failure you<br />
need to record EF, state if it’s diastolic or systolic dysfunction,<br />
and if it is acute or chronic.<br />
HYPERTENSIVE CRISIS<br />
Hypertensive Urgency: SBP >180 or DBP> 120 with<br />
minimal or no target end organ<br />
damage.<br />
Hypertensive Emergency: Acute rise in BP with end organ<br />
damage noted. Neurologic<br />
(hemorrhages, encephalopathy,<br />
papilledema), cardiac (ACS, HF,<br />
aortic dissection), or renal<br />
(proteinuria, hematuria, renal<br />
failure).
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