26- Heart Failure

Question 1

cardiac origin, periphery affected

Answer 1

primary heart failure

Question 2

peripheral cause, cardiac affected

Answer 2

secondary heart failure

ex: sepsis

Question 3

can’t empty

Answer 3

systolic HF

Question 4

can’t fill

Answer 4

diastolic HF

Question 5

low EF

Answer 5

systolic HF sign

Question 6

how does the kidney compensate for HF?

Answer 6

tries to increase volume by retaining sodium and water

Question 7

most common cause of RV failure

Answer 7

LV failure

Question 8

symptoms of LV failure

Answer 8

• dsypnea
• diminished exercise capacity
• nocturia
• CNS impairment

Question 9

symptoms of RV failure

Answer 9

• peripheral edema

- edema of bowel wall which can impair med absorption

Question 10

NYHA classification

Answer 10

class I - IV

Question 11

class I

Answer 11

no limitations

Question 12

class II

Answer 12

slight limitation of
activity

25% mortality 1 yr

Question 13

class III

Answer 13

marked limitation

50% mortality 1 yr

Question 14

class IV

Answer 14

symptoms at rest

50% mortality 1 yr

Question 15

PE: pallor, cool extremities, anxiety, dyspnea at rest, pulses normal t rapid, weak, varying BP. Pulmonary rales, pleural effusion

Answer 15

left HF

Question 16

PE: hepatojugular reflux, kussmaul’s sign, congestive hepatomegaly, symmetrical edema

Answer 16

Right HF

Question 17

what is kussmauls’s sign?

Answer 17

paradoxical jugular movement in which the JVD rises when the patient take a deep breath (normally would decrease because of increasing pulmonary pressure)

Question 18

x ray findings for HF

Answer 18

cardiomegaly
pulmonary congestion
pleural effusion
kerley lines

Question 19

risk factors for worse HF prognosis

Answer 19

male
CAD
S3
narrow pulse pressure
High NYHA class
reduced exercise capacity

Question 20

AHA stage A

Answer 20

presence of HF risk factors but no disease and no symptoms

Question 21

AHA stage B

Answer 21

heart disease present but no symptoms

Question 22

AHA stage C

Answer 22

structural heart disease present AND symptoms have occurred

Question 23

AHA stage D

Answer 23

presence of advanced heart disease with continued HF symptoms requiring treatment

Question 24

stage A therapy

Answer 24

ACE inhibitors

Question 25

stage B therapy

Answer 25

ACE inhbitors

maybe also B blocker, diuretics, digoxin

Question 26

stage C therapy

Answer 26

ACEinhibtors and spironolactone, diretics beta blockers

Question 27

stage D therapy

Answer 27

palliative

improve symptoms

Question 28

what do ACE inhbitors prevent?

Answer 28

myocyte hypertrophy
myocyte apoptosis
presynaptic facilitationof NE release
direct myocyte toxicity
proliferation of fibroblasts

Question 29

example of ACEi

Answer 29

enalapril

Question 30

only beta blocker FDA approved for chronic HF

Answer 30

carvedilol