PharmDecks

Menu
Login
Sign Up
Course Content
Hypertension
0/3
Mechanisms of Blood Pressure Regulation
07:36
Pathogenesis of Primary and Secondary Hypertension
41:56
End of Topic Quiz
00:20:00
Ischaemic Heart Disease
0/5
Atherosclerosis
14:37
Plaque Formation
06:06
Pathophysiology of Angina
09:44
Pathophysiology of Myocardial Infarction
11:49
End of Topic Quiz
00:20:00
Heart Failure Mechanisms
0/4
Types of Heart Failure (Systolic vs. Diastolic)
09:06
Pathophysiological Changes in Heart Failure
07:56
Clinical Manifestations and Stages of Heart Failure
02:59
End of Topic Quiz
00:20:00
Alzheimer’s Disease
0/4
Pathogenesis of Alzheimer’s Disease
08:53
Genetic and Environmental Risk Factors
07:24
Clinical Stages and Symptoms
04:27
End of Topic Quiz
00:20:00
Parkinson’s Disease
0/4
Pathogenesis of Parkinson’s Disease
13:53
Motor and Non-Motor Symptoms
31:18
Risk Factors and Progression
03:43
End of Topic Quiz
00:20:00
Pain Pathways and Analgesia
0/5
Types of Pain
11:47
Pathways of Nociception
08:14
Mechanisms of Pain Modulation
24:13
Pharmacological and Non-Pharmacological Pain Management
24:16
End of Topic Quiz
00:20:00
Diabetes Mellitus
0/5
Types of Diabetes
05:58
Pathophysiology of Hyperglycaemia
06:15
Acute and Chronic Complications
17:05
Management Strategies
05:54
End of Topic Quiz
00:20:00
Thyroid Disorders
0/4
Hypothyroidism
05:39
Hyperthyroidism
12:07
Pathophysiology of Thyroid Hormone Synthesis and Regulation
07:53
End of Topic Quiz
00:20:00
Cushing’s vs Addison’s Disease
0/4
Cushing’s Disease
13:41
Addison’s Disease
11:58
Key Differences Between Cushing’s and Addison’s Disease
15:40
End of Topic Quiz
00:20:00
Cardiovascular & Endocrine Pathophysiology

Introduction to Heart Failure

  • Heart failure is a chronic condition where the heart cannot pump blood effectively enough to meet metabolic demands.

  • Symptoms include:

    • Breathlessness

    • Fatigue

    • Fluid retention

  • Correct classification of heart failure is essential for appropriate medicine selection and counselling.

Classification of Heart Failure (UPDATED NICE)

Heart failure is classified based on left ventricular ejection fraction (LVEF).

Heart Failure with Reduced Ejection Fraction (HFrEF)

Definition

  • LVEF ≤40%

  • Impaired ventricular contraction (systolic dysfunction)

Common Causes

  • Ischaemic heart disease

  • Previous myocardial infarction

  • Hypertension

  • Dilated cardiomyopathy

Pharmacological Management

  • Core disease-modifying therapy

    • ACE inhibitor or ARB (or ARNI where appropriate)

    • Beta-blocker

    • Mineralocorticoid receptor antagonist

    • SGLT2 inhibitor

  • Diuretics

    • For symptom relief of congestion (not prognostic)

Heart Failure with Mildly Reduced Ejection Fraction (HFmrEF) (NEW NICE EMPHASIS)

Definition

  • LVEF 41–49%

Management

  • Offer an SGLT2 inhibitor (dapagliflozin)

  • Continue or consider:

    • ACE inhibitors or ARBs

    • Beta-blockers

    • MRAs

  • Diuretics for fluid overload

Heart Failure with Preserved Ejection Fraction (HFpEF) (UPDATED)

Definition

  • LVEF ≥50%

  • Impaired ventricular relaxation and filling (diastolic dysfunction)

Common Causes

  • Hypertension

  • Diabetes

  • Obesity

  • Atrial fibrillation

Pharmacological Management (UPDATED)

  • Offer an SGLT2 inhibitor (dapagliflozin)

  • Diuretics for congestion

  • Optimise treatment of comorbidities:

    • Blood pressure control

    • Rate/rhythm control in AF

    • Diabetes management

Comparison of Heart Failure Types

Feature HFrEF HFmrEF HFpEF
LVEF ≤40% 41–49% ≥50%
Main problem Poor contraction Mixed systolic/diastolic Poor relaxation
Disease-modifying therapy Strong evidence Emerging evidence Limited but improving
SGLT2 inhibitors Recommended Recommended Recommended

Conclusion

  • HF classification directly determines treatment strategy

  • SGLT2 inhibitors are now recommended across HFrEF, HFmrEF, and HFpEF

  • Pharmacists are essential in:

    • Medicine optimisation

    • Monitoring renal function and electrolytes

    • Supporting long-term adherence

References

  • NICE, “Chronic heart failure in adults: diagnosis and management”

  • British National Formulary, “Heart failure”

  • NHS, “Heart failure”

  • British Heart Foundation, “Types of heart failure”

Previous
Next
0% Complete