Acute Heart Failure AHF

Question 1

What is acute heart failure?

Answer 1

Acute heart failure is a sudden or rapid onset of symptoms and signs of heart failure, often requiring urgent medical attention.

Question 2

What are the common causes of acute heart failure?

Answer 2

Causes include myocardial infarction, arrhythmias, valvular heart disease, infection, non-compliance with medications, and hypertensive crisis.

Question 3

How is acute heart failure classified?

Answer 3

It is classified based on fluid status (wet or dry) and perfusion status (warm or cold).

Question 4

What are the typical symptoms of acute heart failure?

Answer 4

Symptoms include breathlessness, orthopnoea, paroxysmal nocturnal dyspnoea, fatigue, and reduced exercise tolerance.

Question 5

What are the common signs of acute heart failure on examination?

Answer 5

Signs include raised jugular venous pressure (JVP), peripheral oedema, pulmonary crackles, tachycardia, and hypotension.

Question 6

What is the pathophysiology of acute heart failure?

Answer 6

It involves impaired cardiac output or increased filling pressures, leading to pulmonary congestion and systemic hypoperfusion.

Question 7

What are the risk factors for developing acute heart failure?

Answer 7

Risk factors include coronary artery disease, hypertension, diabetes, atrial fibrillation, and pre-existing chronic heart failure.

Question 8

How is acute heart failure diagnosed?

Answer 8

Diagnosis is based on clinical features, supported by investigations like ECG, echocardiography, chest X-ray, and blood tests.

Question 9

What investigations are performed in acute heart failure?

Answer 9

ECG, chest X-ray, blood tests (e.g., BNP/NT-proBNP, renal function), and echocardiography.

Question 10

What are the chest X-ray findings in acute heart failure?

Answer 10

Findings may include cardiomegaly, pulmonary oedema, Kerley B lines, pleural effusions, and vascular redistribution.

Question 11

What is the role of BNP or NT-proBNP in diagnosing acute heart failure?

Answer 11

Elevated levels suggest increased cardiac wall stress and help differentiate heart failure from other causes of breathlessness.

Question 12

What are the clinical features of pulmonary oedema in acute heart failure?

Answer 12

Severe dyspnoea, orthopnoea, pink frothy sputum, tachypnoea, and crackles on auscultation.

Question 13

What are the differential diagnoses for acute heart failure?

Answer 13

Differential diagnoses include pneumonia, pulmonary embolism, COPD exacerbation, and acute kidney injury.

Question 14

What are the immediate management priorities in acute heart failure?

Answer 14

Priorities include oxygen therapy, diuretics, vasodilators, and addressing underlying causes.

Question 15

What is the role of diuretics in managing acute heart failure?

Answer 15

Diuretics, such as intravenous furosemide, relieve symptoms by reducing fluid overload.

Question 16

When are vasodilators used in acute heart failure?

Answer 16

Vasodilators like nitrates are used to reduce preload and afterload in patients with pulmonary congestion and normal or high blood pressure.

Question 17

How is hypotension managed in acute heart failure?

Answer 17

Hypotension may require inotropes like dobutamine or noradrenaline to improve cardiac output and maintain perfusion.

Question 18

What is the role of non-invasive ventilation (NIV) in acute heart failure?

Answer 18

NIV, such as CPAP or BiPAP, improves oxygenation and reduces work of breathing in pulmonary oedema.

Question 19

What are the complications of untreated acute heart failure?

Answer 19

Complications include multi-organ failure, cardiogenic shock, arrhythmias, and death.

Question 20

How is cardiogenic shock related to acute heart failure?

Answer 20

Cardiogenic shock occurs when severe cardiac dysfunction leads to inadequate tissue perfusion, a life-threatening complication of acute heart failure.

Question 21

What lifestyle advice should be given to patients after acute heart failure?

Answer 21

Avoid excessive salt and fluid intake, adhere to prescribed medications, monitor weight daily, and report worsening symptoms promptly.

Question 22

What is the long-term management of acute heart failure?

Answer 22

Optimising treatment for underlying causes, managing comorbidities, regular follow-up, and initiating guideline-directed medical therapy.

Question 23

What is the role of echocardiography in acute heart failure?

Answer 23

Echocardiography assesses ejection fraction, wall motion abnormalities, and structural heart disease, guiding management.

Question 24

What medications are typically continued or initiated after stabilisation of acute heart failure?

Answer 24

ACE inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and diuretics as indicated.

Question 25

Why is early recognition and treatment of acute heart failure critical?

Answer 25

Early intervention reduces mortality, prevents complications, and improves short- and long-term outcomes.