Cardiovascular

Question 1

What is heart failure?

Answer 1

the inability of cardiac output to meet the physiological demands of the body

Question 2

What are symptoms of left ventricular failure (LVF)?

Answer 2

Paroxysmal nocturnal dyspnoea. wheeze, nocturnal cough with pink sputum caused by pulmonary oedema

Question 3

What can cause symptoms of right ventricular failure (RVF)?

Answer 3

usually caused by LVF or lung disease, peripheral oedema and ascites

Question 4

What are causes of left-sided heart failure?

Answer 4

Coronary artery disease
Hypertension
Aortic valve disease
Mitral valve disease
Myocardial disease

Question 5

What are the causes of right-sided heart failure?

Answer 5

left sided heart failure
tricuspid valve disease
pulmonary valve disease
pulmonary vascular disease

Question 6

What is class 1 of the New York Heart Associate classification of heart failure?

Answer 6

No limitation of physical activity

Question 7

What is class 2 of the New York Heart Associate classification of heart failure?

Answer 7

Slight limitation of physical activity

Question 8

What is class 3 of the New York Heart Associate classification of heart failure?

Answer 8

Marked limitation of physical activity

Question 9

What is class 4 of the New York Heart Associate classification of heart failure?

Answer 9

Inability to carry out physical activity

Question 10

What are the complications of heart failure?

Answer 10

Renal failure
Valve dysfunction
Stroke

Question 11

What are the investigations for heart failure?

Answer 11

Bloods - FBC, U&Es, LFTs, TFTs, Lipid profile, BNP

Chest X-ray
Echo
ECG

Question 12

What does BNP show?

Answer 12

How much the myocytes are stretched.

Question 13

What are the findings on a chest X-ray that indicate heart failure?

Answer 13

Alveolar oedema
Kerly B lines
Cardiomegaly
Dilated upper lobe vessels
Pleural Effusion

Question 14

what is the purpose of the echo?

Answer 14

Aims to identify cause and assess function of the heart

Question 15

what does reduced myocardial efficiency lead to?

Answer 15

Increased work load
decreased cardiac output
decreased contractility

Question 16

what does an increased workload, decreased cardiac output and decreased contractility lead to?

Answer 16

Activation of compensatory mechanisms

Question 17

what are some of the compensatory mechanisms in heart failure?

Answer 17

Activation of RAAS
Activation of sympathetic nervous system
Increased myocyte size

Question 18

what does RAAS activation lead to?

Answer 18

causes Na+ ion and H2O retention, and peripheral vasoconstriction –> increased preload

Question 19

what does the activation of sympathetic nervous system lead to?

Answer 19

increased heart rate and leads to increased cardiac damage

Question 20

what does chronic activation of compensatory mechanisms lead to?

Answer 20

worsens heart failure and leads to increased cardiac damage

Question 21

what is the cause of cardiac dilation?

Answer 21

increased end diastolic volume

Question 22

what is the raised JVP linked to?

Answer 22

right-sided heart failure and fluid overload

Question 23

what causes hepatomegaly in heart failure?

Answer 23

congestion of the hepatic portal circulation

Question 24

What is the conservative treatment for heart failure?

Answer 24

smoking cessation
weight loss
promotion of a healthy diet and exercise