Heart Failure Explained - HFrEF vs HFpEF (Systolic vs Diastolic Heart Failure)

[@RhesusMedicine]

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[@alibaldiwala1604]

Shoutout to Rhesus Medicine and alike YT channels which make our lives easier with such great videos!

[@tabascocat5102]

What is the significance or importance of the Ejection Fraction (EF), when it doesn't indicate the amount of blood leaving the heart? Eg: If the EF was 65% (good) but the cavity only sucked in 10mls, then the output would be 6.5mls, which is VERY small, but a 65% EF will still sound good. Why isn't 'Stroke Volume' used all the time, telling us how much is actually ejected, not how much of whatever capacity is left behind.

[@hiranp5054]

Because we cant classify heart failure based on stroke volume, in both cases of heart failure stroke volume is low,but with ejection fraction we can identify the pumping ability of heart and classify heart failure.

[@xym8744]

as a first year IM resident, this is so helpful, thank you so much!

[@karamatullah5280]

🎯 Key Takeaways for quick navigation: 00:00 *🫀 Heart Failure Overview* - Heart failure defined as inability of heart to meet body's perfusion demands. - Two main types: systolic (HFrEF) and diastolic (HFpEF) heart failure. - Definitions include cardiac output, stroke volume, systole, and diastole. 02:03 *💔 Causes of Heart Failure with Reduced Ejection Fraction* - Linked with coronary artery disease, chronic volume overload, dilated cardiomyopathy. - Increased afterload contributes to reduced ejection fraction. - Examples include severe aortic stenosis, uncontrolled hypertension. 03:43 *💓 Causes of Heart Failure with Preserved Ejection Fraction* - Mainly associated with diastolic dysfunction and stiff left ventricle. - Conditions like left ventricular hypertrophy, restrictive cardiomyopathy contribute. - Right-sided heart failure often secondary to left-sided heart failure. 05:18 *🫁 Signs and Symptoms of Heart Failure* - Dyspnea, orthopnea, paroxysmal nocturnal dyspnea linked to pulmonary congestion. - Raised jugular venous pressure, hepatomegaly, peripheral edema due to fluid backlog. - Clinical diagnosis includes history, physical examination, and laboratory tests. 07:23 *💊 Diagnosis and Treatment Options* - Diagnostic markers like NT-proBNP and imaging techniques such as echocardiography. - Pharmacological management includes medications targeting mortality reduction and symptom management. - Treatment options vary for HFrEF and HFpEF, including medication and non-pharmacological therapies. 11:55 *⚕️ Prognosis and Management Strategies* - Mortality rate of heart failure is high, often leading to progressive disease. - Assessment tools like NYHA and ACC classifications help in risk stratification. - Lifestyle improvements, risk factor control, and non-pharmacological interventions are recommended. Made with HARPA AI

[@debigdogk9563]

Awesome teaching, and very well tailored, thank you for the great work ❤❤❤❤❤❤

[@seanodonnell4713]

10:12 bit confused you mentioned that you wouldn’t give ARNI with ACEI due to increased risk of Angiodema as they both break down bradykinin just wondering if this was an error or did I mis read it

[@Bill.R.124]

Excellent video. As a nursing professor, I love these videos and share them with my students. I use the Rhesus, Alial Medical, and Osmosis videos religiously. In the United States I've never even heard of the first two classes you mentioned. Seems like ACEi, BB's, and diuretics are the mainstay. I looked up ARNIs and Entresto is prescribed in the US apparently, but rarely see that in my practice in the ED where I work once a week as an RN.

[@alisyed294]

I’m a physiotherapy student and they haven’t taught us about the ARNIs as far as I’m aware, but they mentioned the SGLT2 inhibitors. Apparently they’re fairly recent, and very effective. Not just in heart failure but used in diabetes and other diseases too. They’ve been shown to greatly reduce progression of CAD, and reduce CHF related hospital admissions and deaths. They’re good for lowering blood sugar in diabetes but also lowering blood pressure in hypertension. Not mentioned in this video, but long acting nitrates are also sometimes used as venodilators to reduce preload. Not as common as the other drugs though, so was wondering if you’ve come across those being used at all?

[@preciousnzeakor4018]

I still don't understand why Ejection fraction is normal in diastolic failure. If the heart isn't relaxing enough, then it can't fill to it's normal capacity. This invariably reproduces EDV. If SV is normal, then EJ should increase. Please explain this sir. I'm confused

[@mariajoselaverde6534]

The thing is that when it is not filling enough, it is not pumping enough. Both teledyastolic (end dyastole) and systolic (stroke) volumes would be decreased, leaving with a normal ejection fraction, but not implying the patient has not a problem.

[@marthachanda1997]

Election fraction is stroke volume over end diastolic volume multiplied by 100%...in diastolic hf the heart does not fill up enough so the end diastolic volume is low but since systole is normal the stroke volume will almost be equal to the end diastolic volume now multiple that by 100%the ejection fraction will be normal but in systolic heart failure the stroke volume is low but the end diastolic volume is high ...multiply that the ejection fraction will be high ...

[@ss_aa30]

I don't understand, why are we blocking NP if it antagonises the RAAS system? If the antagonisation reduces mortality why give a drug that stops this?

[@AnahiCamarillo]

Thank you so much, you really help me a lot :)) Blessingsss

[@xxamulyaxx]

Great detailed video

[@RhesusMedicine]

Thanks!

[@DuncanMaggs]

Where did the 50% mortality in 5 years figure come from please?

[@anestocharles5970]

Great Video! What resources/materials/textbooks did you base this video off of?

[@RhesusMedicine]

Thanks Anesto, I used several publications from different journals, as well as resources like BMJ Best Practice. I'll see if I can put links to the publications in the description 😊

[@هاشمالشيخ-ض2ر]

it is really helpful video

[@RhesusMedicine]

Thank you, glad it helped :)

[@ca0los]

Muchas gracias, muy informativo ;)

[@erinconnell2198]

this video slaps 😄

[@RhesusMedicine]

Had to look up "slaps", thanks 😎

[@bacsidon]

It’s a very useful video. How do you create the images and what software are you using? Thank you.

[@purplegalaxy1234]

Where are your references please?

[@razazarshen7917]

Super✔✔

[@kathym6603]

Now we know that heart failure is not a simple issue.

[@gauravchaubey7788]

sir iska kya treatment hai ....106ms since bradycadia with 1st degree av block .. 528/509 ms incomplete right bundle branch block 264 left ventricular hypertrophy with repolanzation abnormality ... 206 ms prolonged Qt 108/1071ms abnormal ecg 90/49/137 degrees .. gross biatrial enlargement no regional wall motion abnormality seen lvef 50% grade 3 diastolic dysfunction raised lvedp mild rv systolic dysfunction rv tdi 8m/s ias/ivs inactivity no intracadic clot/vegetation pe seen heart rate 56 bpm sir iska kya treatment hai Bp= 100/66 mm of hg spo2 100% T = 96.8F P = 72b/m R= 20 b/m Age = 23 weight = 47

[@dailydoseofmedicinee]

🙏👍

[@BostonFreedom-r1d]

Lee Kevin Rodriguez Jennifer Jackson Anthony

[@Zizuthecreatorlamarwest]

causes: hypertension, obesity.. makes sense, WAIT RENAL DISEASE?!