CHF

Question 1

Left-sided heart failure Sx

Answer 1

decreased forward perfusion and pulmonary congestion

• pulmonary edema
• dyspnea/paroxysmal noturnal dyspnea
• orthopnea (dyspnea when supine)
• crackles
• decreased blood flow to kidneys activates RAAS –> exacerbation of fluid retention

Question 2

Mainstay treatment of left-sided heart failure

Answer 2

ACE-inhibitor

Question 3

Most common cause of right-sided heart failure

Answer 3

left sided heart failure

Question 4

Sx of heart-sided heart failure

Answer 4

JVD/HJR

painful hepatosplenomegaly

dependent pitting edema (due to increased hydrostatic pressure)

Question 5

Histology of right sided heart failure

Answer 5

liver cirrhosis

“nutmeg liver”

Question 6

Why is it important to control chronic lung disease (relative to heart failure)

Answer 6

hypoxic vessels in lung tissue contrict to shunt blood to more oxygenated areas
“hey I don’t have any O₂ for you!”

chronic lung disease –> chronic hypoxia –> chronic vasoconstriction –> increased resistance in pulmonary artery

= pulmonary HTN and hypertrophy of rt ventricle