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Flashcards in Heart Failure Deck (34)
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1

What are the salt and water restrictions advised to patients with heart failure?

< 6g of salt per day, < 1.5L of water per day

2

Which type of heart failure will respond to drugs which prolong survival in heart failure?

HFREF

3

Name some drug classes which can be used to prolong survival in patients with heart failure?

ACE inhibitors/ARBs, beta blockers, spironolactone, vasodilators

4

Name some drug classes which can be used to improve symptoms in patient with heart failure?

Diuretics, digoxin and beta blockers

5

How should beta blockers be started in heart failure and why?

They should be started at a low dose and increased slowly, as they may worsen heart failure in the short-term

6

In which type of heart failure (i.e. left or right) may a CXR be normal?

Right sided

7

What are some signs which may be seen on a CXR of heart failure?

Kerley B lines, ill-defined peri-hilar shadowing, pleural effusions, increased cardiothoracic ratio

8

What is the single most useful diagnostic test for heart failure?

Transthoracic ECHO

9

What blood test is a useful rule out test in patients who have symptoms of heart failure?

BNP

10

In addition to those which are necessary, what are some further investigations which may be useful in patients with heart failure?

Cardiopulmonary exercise tests, coronary angiography, cardiac MRI

11

What are some symptoms and signs of pulmonary oedema which may occur in someone with left sided heart failure?

Tachycardia, dyspnoea, fine crepitations/crackles at the lung bases, pleural effusions

12

A 'gallop rhythm' may be heard on auscultation of somebody with left sided heart failure. What is this?

Tachycardia and a 3rd heart sound

13

What type of sputum will somebody who has pulmonary oedema as a result of left sided heart failure produce?

Pink, frothy sputum

14

What investigations must all individuals who present with symptoms/signs of heart failure have?

ECG, CXR, bloods, ECHO

15

What is a second line drug which is used frequently in the management of moderate-severe heart failure?

Spironolactone

16

What is the only curative option in the treatment of heart failure?

Heart transplant

17

How should you position patients in acute heart failure?

Sit them upright

18

Describe the drugs used in the initial management of acute heart failure?

IV furosemide, morphine and GTN

19

What is the first line therapy to improve prognosis in patients with HFREF?

ACE inhibitor and beta blocker

20

What drug class is used first line in all symptomatic stages of heart failure?

Loop diuretics

21

What drug is used to control ventricular rate in patients with AF, or for symptom relief of severe symptoms in advanced heart failure?

Digoxin

22

Which type of heart failure are implantable devices reserved for? Give two examples of these?

HFREF / cardiac resynchronisation therapy or implantable defibrillator

23

What surgical management can be used for patients with heart failure due to primary valvular disease?

Valve replacement

24

What surgical management can be used for patients with heart failure due to multi-vessel coronary artery disease?

CABG

25

Both types of heart failure reduce the cardiac output. This leads to the upregulation of what two systems in order to compensate?

Sympathetic nervous system and RAAS

26

Right sided heart failure results in failure to clear blood returning from the systemic circulation. This leads to a rise in systemic venous pressure, which can cause what symptoms and signs?

Peripheral oedema, elevated JVP, hepatomegaly

27

Left sided heart failure results in increased pressure in the left atrium and pulmonary circulation, which can cause what symptoms and signs?

Dyspnoea (including orthopnoea and PND) and pulmonary oedema

28

What are some causes of left sided heart failure?

Ischaemic heart disease, valvular disease, cardiomyopathies

29

What are some causes of right sided heart failure?

Secondary to left sided, cor pulmonale, congenital heart disease

30

How is ejection fraction calculated?

(Stroke volume / end diastolic volume) x 100