Heart Failure

Question 1

systolic vs diastolic: differences

Answer 1

HFwrEF vs HF with preserved EF

reduced EF: <40%

Question 2

what system is activated if body senses reduced cardiac output

Answer 2

RAAS and sympathetic nervous system (SNS)

Question 3

presenting features of left ventricular heart failure

Answer 3

as blood backflow to lungs: pulmonary congestion

dyspnea, sob, pleural effusion, increased bun, edema, rales

Question 4

presenting features of right ventricular heart failure

Answer 4

backflow to venous system: pitting oedema of limbs (peripheral oedema)

neck vein distention, hepatomegaly

Question 5

type of diuretics to relieve fluid overload sx

Answer 5

loop/ thiazide; but loop > thiazide (more for BP control)

loop: frusemide, bumetanide
thiazide: HCTZ, metolazone

Question 6

if CrCl is less than 30ml/min, which diuretic can be used in HF?

Answer 6

loop (can use until <5ml/min), thiazide lose effectiveness once <30ml/min

Question 7

adverse effect of diuretics

Answer 7

hypotension, dizziness, decrease urine output, increase BUN (due to lesser renal flow), less electrolytes (K, Mg, Na, Cl)

Question 8

anti-arrhythmic drugs such as amiodarone and procainamide have _______ inotropic effect, which ______ heart contractions and thus cannot be used in HF

Answer 8

negative, weakens

Question 9

which anti-arrhythmic drugs can be specifically used for ventricular arrhythmias

Answer 9

disopyramide, lidocaine, amiodarone

Question 10

which anti-arrhythmic drug has anticholinergic properties

Answer 10

disopyramide