5) Cardiac Failure

Question 1

What are some causes of heart failure?

Answer 1

IHD
HTN
Dilated cardiomyopathy
Valvular heart disease

Question 2

What can cause systolic dysfunction in heart failure?

Answer 2

Increased LV capacity
Reduced LV cardio output
Thinning of myocardial wall
Mitral valve incompetence

Question 3

How can heart failure be classified?

Answer 3

Right sided, left sided or congestive

LV systolic dysfunction or HF with preserved ejection fraction

Question 4

What are the symptoms of left heart failure?

Answer 4

Fatigue
Exertional dyspnoea
Orthopnoea
Paroxysmal nocturnal dyspnoea

Question 5

What are some signs of left heart failure?

Answer 5

Breathlessness
Tachycardia
Cardiomegaly 
3rd or 4th heart sounds 
Basal pulmonary crackles

Question 6

What are some signs and symptoms of right heart failure?

Answer 6

Fatigue
Dyspnoea
Increased JVP
Pitting oedema
Ascites

Question 7

What are some causes of right heart failure?

Answer 7

Chronic lung disease
Pulmonary embolism/hypertension
Pulmonary/tricuspid valve disease

Question 8

How can heart failure be investigated?

Answer 8

Bloods: FBC, U&Es, lipids, BNP
ECG
CXR
Echo

Question 9

What are some pharmacological treatments for heart failure?

Answer 9

ACEi/ARB
Beta blockers
Spironolactone
Diuretics
Ivabradine
Hydralazine

Question 10

What lifestyle modifications are recommended for those with heart failure?

Answer 10

Reduce salt and blood pressure
Increase exercise
Reduce alcohol

Question 11

What interventions can be used in heart failure management?

Answer 11

Valve surgery
Implantable pacemaker and defibrillator
Mechanical assist devices
Heart transplantation