Chronic Heart Failure

Question 1

Definition of clinical heart failure

Answer 1

cardiac output is inadequate for the bodies requirements

Question 2

Poor prognosis of …..% mortality at 1 year

Answer 2

30-40%

Question 3

Symptoms

Answer 3

SOB

Fatigue

Oedema

Reduced exercise capacity

Sudden death

Question 4

Signs

Answer 4

oedema

tachycardia

raised JVP

chest crepitations

3rd heart sound

displaced/abrnomal apex beat

Question 5

Objective evidence of cardiac dysfunction is mandatory because…

Answer 5

heart failure is hard to diagnose on its own

Question 6

chest crepitations

Answer 6

crackling or rattling sounds

Question 7

Objective evidence of cardiac dysfunction can be investigated by

Answer 7

ECHO

Cardiac MRI

Radionucleotide Scan

Left Ventriculogram

ECG

Question 8

BNP

Answer 8

brain natriuretic peptide

elevated in heart failure (low BNP could exclude heart failure)

Question 9

When first investigating - always look at

Answer 9

ECG

BNP

ECHO

Question 10

What causes heart failure?

Answer 10

LV systolic dysfunction

valvular heart disease

paricardial constriction

LV diastolic dysfunction

cardiac arrhythmias

Question 11

Causes of LVSD

Answer 11

ischaemic heart disease

severe AV or MR

(can be inherited, toxic, viral)

Question 12

Diagnosis of LVSD

Answer 12

detailed history (limes disease? alcohol?)

autoantibodies

Question 13

Tests for LVSD

Answer 13

Echo

ECG

CXR

CT coronary angiography

Question 14

LV ejection fraction

Answer 14

continuous biological variable

disease can increase or decrease this variable

Question 15

Pharmacological treatment of heart failure

Answer 15

Diuretic

ACE inhibitors

Beta blockers

aldosterone receptor blockers