PHARMACOLOGY quiz: Cardiovascular Drugs
Document Summary
1/3 combination of systolic and diastolic dysfunction. Underlying causes of heart failure: arteriosclerotic heart disease, myocardial infarction, hypertensive heart disease, valvular heart disease, dilated cardiomyopathy, congenital heart disease. Prognosis: 30 40% of patients die within 1 year of diagnosis, 60 70% die within 5 years, symptoms at rest = 30 70% annual mortality rate, symptoms with moderate activity = 5-10% annual mortality rate. Most common cause of heart failure: left systolic dysfunction secondary to coronary artery disease, 70% of all cases. Most common clinical symptoms: dyspnea, fatigue, fluid retention. Acute heart failure: loop diuretics, very severe hf: a prompt acting positive inotropic agent such as a agonist or phosphodiesterase inhibitor, and vasodilators should be used as required to optimize filling pressures and blood pressure, nesiritide. Chronic heart failure: best treated with diuretics (often a loop agent + spironolactone) plus an ace inhibitor and, if tolerated, a blocker, digitalis may be helpful if systolic dysfunction is prominent.
