CHF-1

Question 1

When CHF is associated with Aortic Stenosis, what medication should NEVER be given? Why?

Answer 1

Nitros

They will precipitate severe hypotension and can lead to myocardial ischemia/injury.

Question 2

What is the median survival in CHF patients? Is there any difference between HFrEF and HFpEF?

Answer 2

4-5 years

No difference between reduced and preserved EF CHF.

Question 3

What is the difference between Stage B and Stage C for CHF?

Answer 3

Stage B = pts with structural disease but have NEVER had symptoms of CHF

Stage C = pts with structural disease and symptoms of CHF

Question 4

What is meant by, “staging is a one-way street”?

Answer 4

You can only advance in staging, once you are stage C, you can never be deemed stage A or B again.

Question 5

What is the difference between Class 1, 2, and 3 for NYHA category?

Answer 5

Class I = No symptoms
Class 2 = Able to do most activities at home, slight symptoms with extreme activity
Class 3 = Physical activity significantly declines, inability to perform daily activities.

Question 6

What is important to remember for lab testing for patients treated with Entresto?

Answer 6

Entresto is partly a neprilysin inhibitor, which inhibits the breakdown of BNP – thus patients on entresto will have falsely elevated BNP, and in order to accurately assess lab value of acute heart failure, you will need to test NT-ProBNP, as this is NOT effected by Entresto.

Question 7

Which B-Blocker is better to use in CHF if pt has elevated BP? What if pt has lower BP?

Answer 7

1) Coreg – if BP is higher.

2) Metoprolol Succinate — if BP is lower.

Question 8

When starting ACE-Inihibitor, you can start as long as Cr is less than what value?

Answer 8

Can start ACE-I in CHF as long as Cr is < 2.5