NB 2023 Notes
GUIDELINE FOR HEART FAILURE 2005 ELANCS
CHADS2 SCORE http://www.soapnote.org/cardiovascular/chads2-calculator/
HF ALGORITHM EAST LANCS. HARD TO FIGURE OUT!
ERECTILE DYSFUNCTION AND CORONARY DISEASE MEDICONF 2012
RESUSCITATION COUNCIL ANAPHYLAXIS AND BASIC LIFE SUPPORT http://www.resus.org.uk/pages/mediMain.htm
http://www.pccj.eu FREE ON LINE PRIMARY CARE CARDIOVASCULAR JOURNAL
BP ARTICLE AMBULATORY MONITORING
CARDIOLOGY HF 2011 PPT MEDICONF
SUMMARY OF NICE BP GUIDELINE 2011 http://www.bhsoc.org/docs/NICE_Hypertension_Guideline_Update.doc
DOWNLOADED SUMMARY OF NICE GUIDELINE 2011 FROM BHS
PULSE SUMMARY OF NICE BP GUIDANCE APRIL 2012
SUDDEN ARRYTHMIC DEATH SYNDROME http://www.sads.org.uk/
Cardiac and Stroke Networks in Lancashire and Cumbria is at http://www.csnlc.nhs.uk There are local documents on the site
Here is a pdf of CHADS2 CHADSVASC and HAS BLED
HBP MANAGEMENT INCLUDING LIFESTYLE
WELLS SCORE PE http://www.mdcalc.com/wells-criteria-for-pulmonary-embolism-pe/
WELLS SCORE DVT http://www.mdcalc.com/wells-criteria-for-dvt/
NICE CG144 MANAGEMENT OF VENOUS THROMBO EMBOLIC DISEASES
http://www.nice.org.uk/guidance/CG144/chapter/introduction
LIPID LOWERING DR KUMAR MAY 2014
ANNUAL CARDIOLOGY UPDATE June 9 2015
ALLERGY 1-5 FROM SYMPOSIUM ON ALLERGY YHPA MAY-JUNE 2016
ATRIAL FIBRILLATION STEP BY STEP GUIDE
HBP Biggest benefit for least work only 50? Identified
24H BP or 14x HBPM [morning and evening]
BHS Guideline A +- C+- D [BFZ or HBP
indapamide]
Sporonolactone best 4th agent [watch K+] 25-50 mg [Gynecomastia only with 100mg] 1 in n15 rise K+ to 6s and have to come off.
Furosemide has half life of 2h so of no use
Special case RF here can’t use ace BFZ does not work use Doxazosin and Moxonidine
In CKD DM Stroke target 130/80 Too much lowering leads to falls
Secondary HBP
Resistant= 3 agents and still up
Commonest is sleep apnoea
Drug induced NSAID Mirabegnon Tricyclics High dose Venlafaxine
Are they taking the meds?
Renal failure
Rare Adrenal adenoma think if low K+[2.9] on BFZ
Cushings [appearance will alert]
Hypothyroidism
Renal Artery Stenosis [ Excess drop in Egfr when ace started 16% ok 50% not]
HBP check eye ecg renal function
Use large cuff if large arm or will read too high
Big difference in both arms refer
Psuedo HBP where the brachial arteries very thickened on old people and can be felt. These people will not have any target organ damage
Preoperative assessments up to 160/100 is ok 140/90 Clinic 135/85 HBPM
HF
Symptoms may precede signs
Lt heart >crackles Rt heart>ankle swelling
Causes Myocardium Valves [rare- pericardium constricting heart] AF
Do ECG BNP ECHO
Don’t do BNP if has had an MI proceed to ECHO. BNP increased in CKD reduced if on ace diuretic or overweight
Pre HF is LV dysfunction [either systolic contraction or diastolic filling]. Treat as HF also if angina treat as HF
Treat HBP Cholesterol with statin overweight and pre diabetes
Triple therapy ACE + B Blocker + spironolactone or epleronone [check K+]
Diuretic [Furosemide or Bumetanide] to reduce dyspnoea.. allow some ankle edema to persist
Start small dose of ace then add small dose of B Blocker [Bisoprolol]
In diabetes MF and gliflozins best effect on the HF
Chest X will have been done if crackles and breathless a CT will differentiate pulmonary fibrosis
HF AND HBP UPDATE 2018
https://www.mdcalc.com/creatinine-clearance-cockcroft-gault-equation This gives creatinine clearance for when prescribing NOACS
HEART FAILURE 2018 CARDIOLOGY UPDATE
Heart Failure YHPA 5 10 19
Causes IHD HBP commonest
HF rEF
Ace/ARB B Blocker
Spironolactone/Epleronone
Furosemide
ICD if IHD IC Pacer if LBBB
Sacubitil Valsartan stop Ace ARB
Ivabradine if fast heart rate [not if AF]
HFpEF
Cause HBP
ECHO shows LVH and LAtrial Dilatation
Furosemide large doses Poss add Spironolactone