heart failure 

Classifications 

Preserved ejection fractopn 

mildly reduced 

Reduced ejection fraction 

NYHA - class i, Ii, iii, IV

Difference in treatment goal between the two: 

Heart Failure with Reduced Ejection Fraction (HFrEF): To improve the heart's ability to pump blood effectively ( eg ace, ARNI, beta blocker ) 

Heart Failure with Preserved Ejection Fraction (HFpEF): diuretics, blood pressure meds, SGLT2 inhibitor

Investigations 

BNP, Trop T 

CXR - Pulmonary infiltrates, pleural effusion, kerley b lines, cardiomegaly 

ECG 

Treatment 

Ace / ARB / ARNI ( entresto) 

beta blocker, calcium channel blocker - reduce burden to the heart - ci in acute heart failure --> cardiogenic shock

MRA / aldosterone antagonist 

empaglifozin

symptomatic treatment if fluid overload ( bibasal creps, elevated JVP, pitting oedema ) 

• diuresis ( furosemide - hypoK, spirolactone - K sparing) 

• other diuretics ( metalazone, bumetanide ) 

• bumatenide to furosemide conversion 1: 40 

After optimal heart failure treatment 

EF still less than 30% after 3 months of optimal HF treatment 

ICD 

CRT