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Flashcards in Heart Failure Deck (30):
1

What percentage of patients dies within 5 years of diagnosis

25-50%

2

Prevalence in general population is?

1-3%

3

Prevalence in the elderly?

~10%

4

What is systolic failure?

Inability of the ventricle to contract properly resulting in reduced CO and a EF of less than 40%

5

What are the common causes of systolic failure?

IHD, MI, Cardiomyopathy

6

What is diastolic failure?

Inability of the ventricle to relax properly resulting in increased filling pressures and an EF of greater than 50%

7

Causes of diastolic failure?

Cardiac tamponade, restrictive cardiomyopathy, constrictive pericarditis, hypertension

8

Systolic and diastolic failure are mutually exclusive, true or false?

False, they normally co-exist

9

When left ventricular and right ventricular failure co-exist, it is known as what?

Congestive cardiac failure

10

What are the symptoms of left sided heart failure?

Dyspnoea, poor exercise tolerance, fatigue, orthopnoea, paroxysmal nocturnal dyspnoea, nocturnal cough (may have pink frothy sputum), wheeze, nocturia, cold peripheries, weight loss and muscle wasting

11

Symptoms of right sided failure include?

Peripheral oedema, ascites, nausea, anorexia, facial engorgement, elevated JVP, pulsation on neck and face

12

Causes of right sided heart failure include?

Pulmonary stenosis, lung disease and LVF

13

What does acute heart failure refer to?

New onset or sudden de compensation of chronic heart failure leading to pulmonary/peripheral oedema with or without peripheral hypoperfusion

14

How is venous return effected compared to arterial pressure in chronic heart failure?

Arterial pressure is maintained until very late whereas venous congestion occurs much earlier

15

What is low output failure?

Low CO which fails to increase normally upon increased exertion

16

What are the three main mechanisms of failure in low output heart failure?

Pump failure, excessive preload and chronic excessive afterload

17

Give to causes of pump failure

Systolic/diastolic heart failure and decrease in heart rate due to drugs, MI or heartblock

18

Give to causes of excessive preload

Fluid overload and mitral regurgitation

19

Give to causes of excessive afterload

Aortic stenosis or hypertension

20

What is high output failure?

Abnormally high demand from the body means that the normal/increased CO is not sufficient

21

Causes of high output failure?

Anaemia, thyrotoxicosis, pregnancy and Paget's disease

22

In high output failure, which side fails first?

The right side of the heart

23

What criteria system is used to diagnose HF?

Framingham criteria

24

How many of the Framingham criteria must be met?

2 major or 1 major and two minor

25

Name 5 of the major criteria from the Framingham criteria

Crepitations, S3 gallop, cardiomegaly, increased CVP, Raised JVP

26

What are the two main investigations?

ECG and B type naturetic peptide

27

BNP level indicates what?

Myocardial stretch

28

How sensitive is BNP testing?

>90%

29

If either of the two main tests are abonormal, what is the next test?

Echocardiogram (this is the key test for HF and may reveal the cause)

30

What is the definition of heart failure?

When the cardiac output does not meet the requirements of the body's demands.