CHF

Question 0

Estimation of right atrial pressure. Patient lying recumbent, with the head tilted at 45 degree. Giant v waves indicate the presence of tricuspid regurgitation.

Answer 0

Jugular veins

Question 1

Periodic respiration or cyclic respiration. Associated with low cardiac output.

Answer 1

Cheyne- Stroke Respiration

Question 2

Tender and may pulsate during systole if tricuspid regurgitation is present.consequence of increased secondary tohepatics ressure in the hepatic veins and veins draining the peritoneum.

Answer 2

Abdomen and extremities

Question 3

Elevation of resting metabolic rate; inorexia, nausea and vomiting due to the congestive hepatomegaly and abdominal fullness. Elevation of circulating concentrations of cytokines such as TNF; and impairment of intestinal absorption due to congestion of the intestinal veins.

Answer 3

Cardiac cachexia

Question 4

The decrease cardiac output in HF patient results in an “ unloading” of high pressure baroceptors (circles) in the left ventricle, catorid sinus, and aortic arc. This unloading leads to the generation of afferent signals to the central nervous system,that stimulate cardio regulatory centers in the brain which stimulate the release of arginine vasopression from the posterior pituitary AVP for anti diuretic hormone is a powerful vasoconstrictor that increases the permeability of the renal collecting ducts, leading to the reabsorption of free water.

Answer 4

Activation of neuro hormonal system in the heart failure

Question 5

Initial decline in the hearts pumping capacity.

Answer 5

Pathogenesis of heart failure with a depressed ejection fraction

Question 6

Rhythm, LVH or a prior MI ( presence or absence of Q waves), QRS width

Answer 6

ECG

Question 7

Semiquantitative assessment of LV size and function ( EF )

Answer 7

2-D echocardiogram/ Doppler