15863910
Description
Mind Map by Nicky B, updated more than 1 year ago
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Created by greenfylde
about 11 years ago
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Copied by Nicky B
about 6 years ago
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breathlessness (dyspnea)
- Anxiety
- Asthma
- COPD
- Lung cancer (py or 2ndry)
- Pneumonia
- PE
- Stridor
- Upper airway obstruction (foreign body, anaphylaxis, epiglotttis, extrinsic compression)
- Upper airway obstruction (foreign body, anaphylaxis, epiglotttis, extrinsic compression)
- Cardiac Failure
- epidem: incidence up w/age, 50% dead 5y
- causes: CAD (also IHD, cardiomyopathy, hypertens)
- types
- R sided
- Cor pulmonale (R sided heart fail due to resp cause eg COPD)
- peripheral edema
- Cor pulmonale (R sided heart fail due to resp cause eg COPD)
- Lsided
- pulmonary edema
- pulmonary edema
- Both = Congestive (CCF)
- Chronic more common, Acute bad prog
- R sided
- pathphys: compensate -> overwhelmed, activate renin/angiotens/aldost -> periph vasoconstric + sodium retain
- venous press up -> edema, outflow resist up so CO down, bad for contractility, chronic symp nervous system activation (down reg B receptors)
- myocard remodelling, abnormal Ca ++ homeostasis, natriuritic peptides released b/c stress, ADH up
- myocard remodelling, abnormal Ca ++ homeostasis, natriuritic peptides released b/c stress, ADH up
- venous press up -> edema, outflow resist up so CO down, bad for contractility, chronic symp nervous system activation (down reg B receptors)
- symps
- exertional dyspnea (or if bad, resting), orthopnea, PND, fatigue
- exertional dyspnea (or if bad, resting), orthopnea, PND, fatigue
- signs
- cardiomegaly, S3 and S4, tachy, hypotens, bi-basal crackles, pleural effusion, ankle edema, ascites, tender hepatomegaly; with liver symps, can get jaundice later on
- cardiomegaly, S3 and S4, tachy, hypotens, bi-basal crackles, pleural effusion, ankle edema, ascites, tender hepatomegaly; with liver symps, can get jaundice later on
- investigs:
- bloods
- FBC, LFT, U+E, tropoins (if acute), BNP, TFT
- FBC, LFT, U+E, tropoins (if acute), BNP, TFT
- CXR
- cardiomegaly, pulm congestion, fluid in fissures, Kerley B lines, pulm edema
- cardiomegaly, pulm congestion, fluid in fissures, Kerley B lines, pulm edema
- ECG
- ichemia, hypertension, or arrhythmai
- ichemia, hypertension, or arrhythmai
- Echo
- chamber dimension, systolic + diastolic funct, regional wall motion abnorms, valvular heart disease, cardiomyopathies
- chamber dimension, systolic + diastolic funct, regional wall motion abnorms, valvular heart disease, cardiomyopathies
- Others: Nuclear cardiology, Cardiac MRI, Cardiac catheter, cardiac biopsy, cardiopulm exercise test, 24hr ECG)
- bloods
- Treatment
- Lifestyle
- Monitor
- Drugs
- diruetics (loop + thiazaide) for symps not surviv
- ACE INHIBITORS
- improve prog!!!!
- improve prog!!!!
- B blockers
- Aldost antags
- spirinolactone + eplerenone: improve survival!
- spirinolactone + eplerenone: improve survival!
- cardiac glycosides eg digox (for symp relief)
- diruetics (loop + thiazaide) for symps not surviv
- Nonpharm
- Revasculariz
- pacemaker
- Heart transplant
- Revasculariz
- Lifestyle
- epidem: incidence up w/age, 50% dead 5y
- Other: Infect (bronchitis, bronciectasis exac, anaphylaxis, pleural effusion, pneumothorax, fibrosis, tb obesity, chest wall injury, metabolic acidosis)
- valvular disease
- see valvular disease chart
- see valvular disease chart
- Arrythmia
- see notes
- see notes
- Cardiac tamponade
- Acute coronary syndrome (incl MI, angina)
- see 'chest pain' flow chart
- see 'chest pain' flow chart
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