Beta-Blockers in Congestive Heart Failure - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 05-11-2012
callmerocky2's Avatar
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 187
Threads: 28
Thanked 101 Times in 56 Posts
Reputation: 111
Drug Beta-Blockers in Congestive Heart Failure

So, FA says we are not supposed to use Beta Blockers in decompensated CHF but I came across a question in UW where a pt who had MI 2 yrs ago, lately started having dyspnea at exertion, ankle swelling after morning walk n stuff.. Clearly exacerbation of CHF and the answer to the ideal treatment for that patient turned out to be CARVEDILOL..!

Can anyone explain how??
Reply With Quote Quick reply to this message



  #2  
Old 05-11-2012
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 194
Threads: 21
Thanked 145 Times in 84 Posts
Reputation: 155
Default

Well, this is a bit more then what we need for step 1, but New york heart association classification divides the heart failure into 4 classes.
The 4th class speaks about having signs of heart failure at rest and not being able to do even the morning walk you have wrote, only in class 4
B blockers will be contraindicated in all the other class they are still used, the patient you described is in class 3 in which BB can be still used.

Your patient has just moved from class 2 to 3
it doesnt mean he is decompensating, so it doesnt mean he is in acute decompensation but something that has been developing slowly over time.

Hope it helps.
Reply With Quote Quick reply to this message
  #3  
Old 05-11-2012
Hope2Pass's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,684
Threads: 213
Thanked 1,590 Times in 660 Posts
Reputation: 1600
Default

Carvedilol and Labetalol are two non selective Beta and Alpha antagonists. They decrease mortality in MI.

I think its because with B2 inhibition you will have no vasodilation which counteracts A1 inhibition causing vasoconstriction. So your TPR doesn't change but you just widen the pulse pressure (I think). Also, with B1 blockage you will decrease the HR & Contractility and therefore reduce the workload on the heart. And since there is no change in TPR, there is no reflex in HR.
Reply With Quote Quick reply to this message
  #4  
Old 05-11-2012
USMLE Forums Veteran
 
Steps History: Not yet
Posts: 205
Threads: 58
Thanked 19 Times in 16 Posts
Reputation: 29
Default

I came across that question a few days ago , and it said that previously , b-blockers were avoided (before1990)but now it is recommended highly
so i think without much details that it is used for CHF
Reply With Quote Quick reply to this message
  #5  
Old 05-11-2012
callmerocky2's Avatar
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 187
Threads: 28
Thanked 101 Times in 56 Posts
Reputation: 111
Default

But then i am sure FA is also upto date..
Reply With Quote Quick reply to this message



Reply

Tags
Cardiovascular-, Pharmacology-, Physiology-

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Why beta blockers and hypertension? flowerlady USMLE Step 1 Forum 6 11-13-2012 11:06 PM
Beta blockers and lipid metabolism steps_8186 USMLE Step 1 Forum 2 03-09-2012 07:28 AM
CHF with AF why not beta blockers instead of digoxin! docoftheworld USMLE Step 2 CK Forum 11 06-08-2011 04:12 PM
Beta blockers in the treatment of Pheochromocytoma! Zagaris USMLE Step 1 Forum 3 07-16-2010 09:04 AM
Beta One Selective Beta Blockers rasheed USMLE Step 1 Mnemonics 3 11-26-2009 10:12 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)