Heart Failure

Question 1

Systolic heart failure

Answer 1

Ventricles can’t pump enough during systole

Question 2

Diastolic heart failure

Answer 2

Not enough blood fills in ventricles in diastole

Question 3

Systolic and diastolic heart failure leads to

Answer 3

Congestive heart failure

Question 4

Ejection fraction?

Answer 4

Portion of blood pumped out the left ventricle

Question 5

Normal ejection fraction

Answer 5

50-70

40-50= borderline

<40= systolic heart failure

Question 6

Diastolic heart failure features

Answer 6

Ejection is preserved
Stroke volume is low
Ejection fraction normal
Thick ventricle walls mean not enough blood flows in

Question 7

Left ventricle heart failure feature

Answer 7

Blood backed up into lungs
Pulmonary hypertension
Pulmonary oedema

Question 8

Symptoms of LV heart failure

Answer 8

Dyspnea
Orthopnea- difficulty breathing when lying flat

Crackles / roles on auscultation

Question 9

Severe left ventricular heart failure

Pulses alternans

Answer 9

Alternating strong + weak peripheral pulses

Ejection fraction low

Stroke volume low

More blood stays in ventricle

Next systole muscle is stretched further

Question 10

RVHF symptoms and signs

Answer 10

Blood backed up in the body
Jugular distension

(Can been seen when patient at 45 degrees)

3cm above sterna angle

Question 11

RV HF blood backs up so…

Answer 11

Blood goes to liver + spleen so it en,argues

Excess fluid moves into interstitial spaces, collects in peritoneum and produces ascites

Pitting oedema in legs

Question 12

Left sided heart failure can cause

Answer 12

Right sided heart failure (common)

And vice versa

Patients usually have symptoms of both

Question 13

Symptoms of right ventricle heart failure

Answer 13

Arterial remodelling

3 beats (new beat ) on auscultation

Question 14

advanced heart failure symptoms

Answer 14

Decreased tissue perfusion resting sinus tachycardia
Cool,pale,cyanotic extremia
Ventricular stroke volume down

Question 15

Diagnosis heart failure

Answer 15

ECG chest only

Arrhythmias

Question 16

Natriuretic peptide level for heart failure

Answer 16

Heart failure > 400 pg/ml

Question 17

Classification of heart failure

Answer 17

Clsss 1= symptoms of extreme extertion
Class2= moderate extertion
Class 3= mild extertion
Class 4= rest

Question 18

Treatment for heart failure right side o and left side

Answer 18

Treated the same

Question 19

Treatment for heart failure

Answer 19

Manage associated conditions (hypertension, diabetes , ischemic heart disease, rheumatic factor)

Lifestyle mods

Question 20

Drugs for heart failure

Answer 20

Beta blocker + ace or angiotensin receptor blocker

Class 2 + diuretic

Class 3 + aldosterone antagonist + vasodilation

Class4+ digoxin

Question 21

Drugs need to be administered how

Answer 21

Start at low dise then increased to max rolerable load

Question 22

If ischemic then what therapy

Answer 22

Aspirin and statin need t Be added to therapy

Question 23

automatic implantable cardioverter defibrillator applied when

Answer 23

Left ventricle ejection fraction below 35
Or

Recurrent ventricular tachycardia

Or

Malignant arrhythmias

Question 24

When do you need cardiac desynchronisation therapy

Answer 24

When QRS over 120ms

Question 25

If all other measures fail what do you do

Answer 25

Heart transplant Left ventricle assist device LVAD can be used to hold some till transplant or to cure others

Question 26

Acute decomposed heart failure

Answer 26

Congestive heart failure progressively worsens 02 sat <90% = supplement 02 02< 80% =assisted ventilation

Question 27

Heart failure affects kidney how

Answer 27

02 sats low | Can’t perfuse kidney so volume overload + pulmonary congestion

Question 28

Treatment for volume overload + pulmonary congestion

Answer 28

IV loop diuretic

Question 29

Who uses intravenous inotropic agents? Name?

Answer 29

Low ejection fraction Severe hypotension End organ dysfunction