28 Chronic HF
- systolic: drugs improve mortality
- diastolic: no specific therapy, no real treatment
Systolic
- all the results bad for a weak heart (chronic systolic HF)
- good for chronic not acute
- A-BEAM spotlight on heart: the beta-1 selective antagonists primarily suppress adrenergic stimulation of the heart (cardioselective)
- Broken heart strings under A-BEAM spotlight: cardioselective beta blockers are useful in the acute treatment of MI and other acute coronary syndromes (ACS)
- Failing heart balloon in the A-BEAM spotlight: cardioselective beta blockers are useful in the management of chronic heart failure
- Extinguished alpha candle on CARVED candleholder: carvedilol is a nonselective beta blocker and alpha-1 blocker
- CARVED candleholder next to failing heart: carvedilol (in addition to cardioselective beta blockers) is useful in the management of chronic heart failure.
- Angel: beta blockers (e.g. carvedilol and cardioselective agents) reduce mortality in chronic heart failure and post-MI
- Remodeling: beta blockers reduce cardiac remodeling by protecting the heart from excess circulating catecholamines
- Failing heart balloon: K+ diuretics (e.g. spironolactone, eplerenone) are useful in the treatment of heart failure
- Remodeling: mineralocorticoid antagonists (e.g. spironolactone, eplerenone) prevent myocardial remodeling induced by high levels of aldosterone
- Angel: mineralocorticoid antagonists (e.g. spironolactone, eplerenone) decrease mortality in heart fail
- Lids on chest: spironolactone can cause gynecomastia
- Droopy churro: spironolactone can cause impotence and decreased libido
- eplerenone better for men
- higher HR: heart work harder
- for pts on max dose BB
- low EF: high annual risk of SCD
- monitors heart rhythm, shocks heart when detect dangerous rhythm
- left: LV and RV asynchronized contraction, BBB
- very different from slow heart pacemaker
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