Sunday, November 7, 2010

CHF Board Review Course

Contents
CHF Board Exam Review
CHF Exam Review



A compilation of material from:

1. Online sources

2. CHF Board Review Course

3. JHLT
Heart failure -- Epidemiology
   
POINTS:


          
OUTCOMES


1. Relative improvement in survival over time
2. 50% 5 year mortality
3. Mortality worse as age increases
4. Mortality worse in black men

          ALVD

1. Patients with ALVD have half the mortality of HF patients (5% per year annualized)
2. Risk of death 5X - 8X that of normal age-matched population
3. SOLVD Prevention trial
a. HF developed in 10% untreated ALVD patients per year
b. Further 8% annual risk of death or hospitalization

          MAJOR RISK FACTORS

1. Age, male sex
2. Hypertension, LVH
3. Myocardial infarction
4. Diabetes mellitus
5. Valvular heart disease
6. Obesity

          3 DON'T DOs

1. Don't give Digoxin to patients in NSR with low EF but no hx HF
2. Don't give Diltiazem or Verapamil to patients with low EF but no sx CHF
3. Don't Give nutritional supplements to treat structural heart disease or HF
________________________________________________________________

  • Beta-blockers do not improve O2 consumption
  • The lower the BP, the higher the mortality
  • The lower the MLHF scores, the better the survival
  • The higher the KCCQ score, the better the patient's functional capacity. KCCQ scores do not predict prognosis.