Heart Failure

Question 1

RF of HF

Answer 1

CAD, smoking, MI, HTN, obesity, DM

Question 2

Pathophys of HF

Answer 2

Pump failure –> fluid backup

• LHF –> lungs
• RHF –> systemic

Question 3

How does pt in HF present?

Answer 3

Fatigue, SOB, orthopnea, nocturnal SOB, cough, wheezing, LE edema, nocturia

Question 4

HF physical exam findings

Answer 4

Tachypnea, JVD, rales, wheezing, S3 gallop, edema, hepatomeg, PMI displacement

Question 5

How to diagnose HF?

Answer 5

CXR, echo, BNP, ECG

Question 6

How to treat HF?

Answer 6

• Stable: supportive–O2, morphine, diuretic, vasodilator
• HTN Crisis: O2, IV BB and nitro
• HypoTN: O2, inotrope or vasopressor

Question 7

Diastolic HF

Answer 7

Normal EF and contraction

Question 8

Systolic HF

Answer 8

Low EF and contraction

Question 9

Class 1 HF

Answer 9

Mild. Heart disease but asympt

Question 10

Class 2 HF

Answer 10

Mild. Heart disease, slight sx w/ ordinary activity

Question 11

Class 3 HF

Answer 11

Moderate. Heart disease, sx w/ less than ordinary activity

Question 12

Class 4 HF

Answer 12

Severe. Heart disease, can’t perform physical activity w/o sx or sx at rest

Question 13

Stage A HF (and tx)

Answer 13

At risk for HF, no heart disease

Tx: diuretics, ACEI, ARB, lifestyle changes

Question 14

Stage B HF (and tx)

Answer 14

Heart disease w/o sx

Tx: prevent progression (stage A tx) + BB in CAD

Question 15

Stage C HF (and tx)

Answer 15

Heart disease w/ sx

Tx: (stage A tx) + wt monitor, compress socks

Question 16

Stage D HF (and tx)

Answer 16

Refractory HF

Tx: LVAD + heart transplant (for younger pts)