CVS HF

Question 1

Inability of the ventricle to contract normally

↑LV end diastolic volume (LVEDV)
↑LV end diastolic pressure (LVEDP)
↑systemic vascular resistance
Ejection fraction (EF) is < 40%

Answer 1

SYSTOLIC FAILURE

Question 2

Inability of the ventricle to relax and fill normally

↓compliance - impaired LV relaxation/recoil or increase stiffness
increase LV end diastolic pressure (LVEDP)
normal EF, normal LV end diastolic volume (LVEDV)
EF is > 50%

Answer 2

DIASTOLIC FAILURE

Question 3

IHD, dilated cardiomyopathy, MI

Answer 3

SYSTOLIC FAILURE

Question 4

Myocardial hypertrophy: HTN withLVH, hypertrophic CMP
Myocardial infiltration: amyloidosis, sarcoidosis, hemochromatosis, scleroderma
Inflammatory: constrictive pericarditis

Answer 4

DIASTOLIC FAILURE

Question 5

Hx: Exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea*, nocturnal cough (+ pink, frothy sputum)
PE: Dullness on percussion, crackles, wheeze (‘cardiac asthma’)

Answer 5

LVF

Pulmonary congestion/ edema

Question 6

Pulmonary edema + peripheral hypoperfusion

Answer 6

ACUTE HEART FAILURE

Question 7

Venous congestion

Develops or progresses slowly

Answer 7

CHRONIC HEART FAILURE

Question 8

Excessive preload – can cause ventricular dilation

Answer 8

Mitral regurgitation

Fluid overload: renal failure

Question 9

Chronic excessive afterload - can cause ventricular hypertrophy

Answer 9

Aortic stenosis

HTN

Question 10

Heart disease present, but no limitation of activity

No undue dyspnea from ordinary activity

Answer 10

Functional Class I

Question 11

Slight limitation of physical activity

Comfortable at rest; dyspnea with ordinary physical activity

Answer 11

Functional Class II

Question 12

Marked limitation of physical activity

Comfortable at rest, but less than ordinary activity causes dyspnea

Answer 12

Functional Class III

Question 13

Dyspnea at rest

All types of activities cause discomfort

Answer 13

Functional Class IV