Clinical Syndrome of Heart Failure - HF 2 Flashcards

1
Q

NYHA functional class that is symptomatic with moderate exertion

A
  • II
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2
Q

NYHA functional class that is symptomatic with minimal exertion

A
  • III
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3
Q

NYHA functional class that is symptomatic at rest

A
  • IV
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4
Q

distended jugular veins is a symptom of

A
  • right heart failure
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5
Q

pulmonary rales is a symptom of

A
  • left heart failure
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6
Q

hepatomegaly is a symptom of

A
  • right heart failure
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7
Q

S3 or S4 gallop is a symptom of

A
  • left heart failure
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8
Q

peripheral edema is a symptom of

A
  • right heart failure
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9
Q

orthopnea is a symptom of

A
  • left heart failure
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10
Q

the most common cause of right heart failure

how

A
  • left heart failure

- leads to pulmonary artery pressure which increases afterload on right ventricle

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11
Q

most common presenting symptom of heart failure is

A
  • dyspnea on exertion
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12
Q

heart failure with preserved ejection fraction often due to

A
  • diastolic dysfunction
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13
Q

S3 heart sound due to

A
  • early diastolic filling of a volume overloaded ventricle
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14
Q

S4 heart sound due to

A
  • late diastolic filling/atrial contraction into a stiff ventricle
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15
Q

what can echocardiogram determine in heart failure that is very helpful

A
  • ejection fraction
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16
Q

BNP in heart failure released because of

A
  • cardiomyocytes in response to stretch/strain
17
Q

what drugs do we give for heart failure

A
  • ACE inhibitors
  • ARBS
  • aldosterone antagonists
  • beta blockers
18
Q

neurohormonal effect of ACE inhibitors and ARBs

A
  • reversal of remodeling
  • decreased fibrosis
  • decreased sodium and water retention
  • decreased sympathetic tone
19
Q

hemodynamic effect of ACE inhibitors and ARBs

A
  • afterload reduction via
  • decreased SVR
  • decreased BP
20
Q

result of reversing remodeling

A
  • lowers wall stress

- decreases myocardial oxygen demand

21
Q

result of decreasing afterload

A
  • decrease myocardial oxygen demand

- increases stroke volume

22
Q

contraindications for ACE inhibitors and ARBs

A
  • angioedema to ACE inhibitors
  • bilateral renal artery stenosis
  • advanced renal dysfunction
23
Q

contraindications for aldosterone antagonists

A
  • hyperkalemia

- advanced renal disease

24
Q

what beta blockers do we mostly use to treat heart failure

A
  • carvedilol

- metoprolol

25
Q

big contraindication for beta blockers

A
  • acute decompensated heart failure
26
Q

MOA of digoxin

A
  • inhibits Na+ export via Na+/K+ ATPase

- promotes Ca2+ retention and increases contractile force

27
Q

downside of digoxin

A
  • narrow therapeutic window
28
Q

do diuretics have any neurohormonal effects?

A
  • no
29
Q

benefit of diuretic

A
  • decrease preload which alleviates some symptoms of HF
30
Q

what does the QRS need to be in order to derive benefit from cardiac resynchronization therapy

A
  • > 120
31
Q

signs and symptoms of acute decompensated heart failure

A
  • cold and wet
32
Q

patients with ADHF require

A
  • diuretic to relieve excess fluid retention
33
Q

patients with evidence of hypo perfusion require

A
  • positive inotrope (beta blocker)