Topic 5 Cardio Part 2

• Women with HF are usually older compared to men.
• Women are underrepresented in major HF trials.
• Blacks and Hispanics develop HF at an earlier age and are admitted to the hospital more often compared to Whites.
• Primary CMP or cardiomyopathy is a disease that refers to idiopathic conditions that involve only the heart muscle.
• Secondary CMP is another disease process that causes myocardial disease.
• Dilated cardiomyopathy is the most common type of CMP.
• What are the three types of secondary CMP?

  Dilated, Hypertrophic and Restrictive
• Dilated CMP has diffuse inflammation and rapid degeneration of heart fibers that causes ventricular dilation and blood stasis in the left ventricle.
• Hypertrophic cardiomyopathy is a genetic disorder that causes asymmetric left ventricular hypertrophy without ventricular dilation.
• Hypertrophic CMP is more common in men than women, is diagnosed in young adults and is the most common cause of SCD in young people.
• Restrictive CMP is the least common type that impairs diastolic filling and stretch.
• Primary goal of diagnosing CHF is finding the underlying cause.
• Patient goals for therapy with HF is symptom management, minimizing side effects and decreasing mortality and morbidity.
• The first line drug therapy for HF are ACE inhibitors like Captopril.
• What medication is the first line ACE inhibitor for HF?

  Captopril
• What ARB is used for HF?

  Valsartan
• What beta blocker is used for HF?

  Metoprolol
• What Aldosterone antagonist is used for HF?

  Spironolactone
• What digitalis medication is used for HF?

  Digoxin
• What diuretic is used for HF?

  Furosemide
• What devices are used for HF?

  Implantable cardioverter-defibrillator (ICD) and Cardiac resynchronization therapy (CRT)
• What is the ICD used for?

  Primary prevention for SCD
• When is a CRT used?

  For patients with a LVEF of less than 35%
• If ICD fires once, notify HCP right away.
• Avoid large magnets when wearing an ICD.
• Keep incision dry for 4 days after insertion or as instructed.
• Do not drive while wearing an ICD unless cleared by HCP.
• Travel is not restricted for ICD users but do not have a hand held screening wand directly placed over ICD.
• For HF patients, low sodium diets of 2 grams per day are recommended.
• Advanced heart disease with continued HF requiring advanced therapy require fluid restriction.
• Call HCP if daily weight gain is over 3 lbs over 2 days or 3 - 5 lbs in one week.
• For HF patients, walking and increasing tolerance daily, regular rest periods and cardiac rehabilitation is recommended.
• Nausea is a symptom of digoxin toxicity so patients should report that to the provider.
• Nitroglycerin patches are not used on an as needed basis.
• Peripheral Artery Disease is a thickening of the artery walls leading to narrowing arteries of the upper and lower extremities.
• PAD has the highest incidence in Blacks.
• The leading cause of PAD is atherosclerosis.
• Symptoms of PAD arise when there is a 60 - 70 % blockage.
• AAA is more common in men.
• Sexual problems are common after aortic surgery.