280 Heart Failure: Management

Question 1

Therapeutic targets in managing HFpEF

Answer 1

Control of congestion

Stabilization of heart rate and blood pressure

Efforts at improving exercise tolerance

Question 2

It is is a heterogeneous clinical syndrome most often resulting in need for hospitalization due to confluence of interrelated abnormalities of decreased cardiac performance, renal dysfunction, and alterations in vascular compliance

Answer 2

Acute Decompensated Heart Failure

Question 3

Parameters associated with worse outcomes in ADHF

Answer 3

Blood urea nitrogen level greater than 43 mg/dL

Systolic blood pressure less than 115 mmHg

Serum creatinine level greater than 2.75 mg/dL (to convert to μmol/L, multiply by 88.4)

Elevated troponin I level

Question 4

It reflects the interplay between abnormalities of heart and kidney function, with deteriorating function of one organ while therapy is administered to preserve the other

Answer 4

Cardiorenal syndrome

Question 5

IV Therapi in Acute Decompensated Heart Failure

Answer 5

Inotropic Therapy

Vasodilators

Diuretics

Question 6

It is a calcium sensitizer that provides inotropic activity, but also possesses phosphodiesterase-3 inhibition properties that are vasodilators in action.

It is Long acting; should not be used in presence of low blood pressure; similar effectiveness as dobutamine but effectiveness retained in presence of beta blockers

Answer 6

Levosimendan

Usual dosing: 0.1 μg/kg per min, range, 0.05–0.2 μg/kg per min

Question 7

Most common vasodilator but often underdosed; effective in higher doses

Answer 7

Nitroglycerine

Usual dosing: 10–20 μg/min, increase up to 200 μg/min

Question 8

First line of therapy in volume overload with congestion; may use bolus or continuous dosing

Answer 8

Furosemide

Usual dosing: 20-240 mg daily

Question 9

Beta blocker used in management of HFrEF

Answer 9

Carvedilol, Bisoprolol, Metoprolol succinate

Question 10

Pharmacologic Therapy in HFrEF

Answer 10

ACEI

ARBS

Aldosterone Antagonists

Beta Blockers

Arteriovenous Vasodilators

Question 11

A trial conducted in self-identified African Americans, which studied a fixed dose of isosorbide dinitrate with hydralazine in patients with advanced symptoms of HFrEF who were receiving standard background therapy.

The study demonstrated benefit in survival and hospitalization recidivism in the treatment group

Answer 11

A-Heft

Question 12

It is an inhibitor of the If current in the sinoatrial node, slows the heart rate without a negative inotropic effect

Answer 12

Ivabradine

Question 13

True or False

Low-dose rosuvastatin in patients with HFrEF demonstrated improvement in aggregate clinical outcomes

Answer 13

False

Question 14

Mechanism of anaemia in HF

Answer 14

Iron deficiency

Dysregulation of iron metabolism

Occult GI bleeding