Heart Failure

Question 1

what is heart failure

Answer 1

complex clinical syndrome resulting from functional or structual cardiac disorder which decreases to heart’s ability to fill or eject blood in ventricles

Question 2

symptoms of heart failure

Answer 2

sinus rhythm
dilated left ventricle
left ventricle function is reduced
ejection fraction <55%
left atrium dilated
mitral regurgitation

Question 3

what to do after diagnose heart failure

Answer 3

diagnose cause
acute decompensation
escalate treatment if no response
if good response give standard treatment

Question 4

heart failure terminology

Answer 4

acute vs chronic - classification based of duration of symptoms and speed of onset

high vs low ouput- classification based on if metabolic demands exceeds functioning heart ouput (high) or if heart is unable to meet requirements (Low)

forward vs backward failure - classification based on if predominant features are relating to poor cardiac output such as hypotension and poor peripheral perfusion (forward) or systemic and pulmonary venous congestion (backward)

right vs left sided failure- classification based on shows either left or right side failure features. abdominal discomfort, peripheral oedema (right) or dyspnoea, hypotension (left)

diastolic vs systolic - classification based on if cardiac abnormality is reduced ventricle function during systole or impaired chamber filling during diastole

Question 5

pathopyhsiology sequence

Answer 5

primary myocardial injury
response to injury
augmented function
secondary myocardial injury

Question 6

time course of heart failure

Answer 6

gradual progression of asymptomatic heart dysfunction with no visual symptoms until late stage where death may be imminant

second way is stepwise progression getting worse often from conorary heart disease

third way is sudden death from either other pathway secondary to ventricular arrhythmias

Question 7

preserved vs reduced ejection fraction

Answer 7

reduced - disorder of systole where contraction isn’t stong enough
preserved - disorder of diastole where ventricle muscles are thickened and stiffened so relaxation is impaired and amount of blood entering the ventricle is reduced

Question 8

common causes of heart failure

Answer 8

ischaemic heart disease
hypertension
valvular heart disease leading to stenosis or regurgitation
primary heart muscle disease
secondary cardiomyopathies

Question 9

distribution of heart failure

Answer 9

more common in men and elders

Question 10

signs and symptoms of heart failure

Answer 10

breathlessness
ankle swelling
abdominal swelling
raised JVP