Chronic Heart Failure Treatment

Question 0

Heart failure signs

Answer 0

Elevated JVP
Hepatojugular reflex
3rd heart sound
Gallop rhythm

Question 1

Heart failure symptoms

Answer 1

SOB
Orthopnoea
PND
Fatigue
Ankle swelling

Question 2

Mechanism of ❤️ failure

Answer 2

Systolic failure= contractile problem
Myocardium not contracting as well- damaged by ischaemia- MI, ⬆️BP, chemo, autoimmune, hereditary

Valvular disease- aortic stenosis/ regurgitation. Mitral s/r.

Arrythmias- muscle damage- contraction problem

Question 3

Causes of valvular disease

Answer 3

Age related- degeneration & calcification

Congenital

Endocarditis

Question 4

Treatment of aortic stenosis

Answer 4

Valve intervention

Change valve

Question 5

❤️ failure drugs

Answer 5

ACEi

Diuretics

Question 6

Why use diuretics for systolic heart failure?

Answer 6

⬇️ fluid retention in lung & legs (periphery)

Question 7

What was the first medication used to treat ❤️ failure, 50 years ago?

Answer 7

Digoxin

Question 8

What scale determines how bad heart failure is?

Answer 8

New York classification

1-4

Question 9

What switches off sympathetic outflow thus treats ❤️ failure?

Answer 9

B blockers

Question 10

What blocks RAAS this treats ❤️ failure?

Answer 10

Spirinolactone

ACEi

Question 11

How many neurohormonal blockers should patients with ❤️ failure be on?

Answer 11

3

B blocker
ACEi
Aldosterone antagonists (AAA)

Question 12

What should be monitored in patients being treated for ❤️ failure?

Answer 12

K+
BP
Renal function

Question 13

Who can’t have B blockers?

Answer 13

Asthmatics

Question 14

What can B blockers do to ❤️ rate?

Answer 14

⬇️HR

Question 15

What conditions can cause iron deficiency?

Answer 15

❤️ disease
Chronic kidney failure
COPD

Question 16

What does Perhexiline do?

Answer 16

Inhibits muscle mitochondrial free fatty acid uptake.

Not licensed- side effects!

Question 17

What should patients be prescribed if they are intolerant to AAA?

Answer 17

ARB