CONGESTIVE HEART FAILURE

Question 1

definition of reduced ejection fraction?

Answer 1

lesser than or equal to 40%

Question 1

risk factors in men and women?

Answer 1

men= @ risk of reduced ejection fraction
women= @ risk of persevered ejection fraction

Question 2

definition of persevered ejection fraction?

Answer 2

greater than or equal to 50%

Question 3

NYHA classification for asymptomatic patients?

Answer 3

1

Question 4

NYHA classification for difficulty performing ordinary activities?

Answer 4

2

Question 5

NYHA classification for less than ordinary acitivies?

Answer 5

3

Question 6

NYHA classification for severe symptoms?

Answer 6

4

Question 7

when is ivabradine added to the regimen of congestive heart failure?

Answer 7

heart rate greater than 70 & sinus rhythm (*normal sinus)

Question 8

when is verciguat added to the regimen of congestive heart failure?

Answer 8

symptoms are not improving after 6 months of being hospitalized

Question 9

what to add to black patients that still experience symptoms of heart failure despite being on optimal therapy or that do not tolerate ACEi/ARB/ARNI?

Answer 9

combination hydralazine-nitrates

Question 10

when is digoxin considered?

Answer 10

Suboptimal rate control for AF, or persistent symptoms despite optimized GDMT

Question 11

1st line for persevered heart failure with symptoms of pitted edema?

Answer 11

• add diuretics for fluid

Question 12

1st line for persevered heart failure with no symptoms (with risk factors)?

Answer 12

• add SGLT-2 +/- ACE OR ARB OR MRA OR BB

*highlight that these agents have mortality benefit and therefore, are highly effective.

Question 13

_______ is the most common cause of congestive heart failure with persevered ejective fraction

Answer 13

hypertension

Question 14

how is mild hyperkalemia managed?

Answer 14

mild= 5.5; continue RAAS & monitor after 72 hours

Question 15

how is moderate hyperkalemia managed?

Answer 15

moderate= 5.6-5.9
* half RAAS & recheck in 72 hours
* full dose is re-introduced when K+ levels are lower than 5.0 mmol/L

Question 16

how is severe hyperkalemia managed?

Answer 16

severe= 6.0
* stop RAAS & check within 4-24 hours
* if symptoms are present, recheck in 72 hours
* full dose is re-introduced when K+ levels are lower than 5.0 mmol/L

Question 17

dose of empagliflozin used in diabetics with heart failure?

Answer 17

25mg (*normally, its 10mg).

Question 18

when should the initial dose of digoxin be reduced?

Answer 18

age > 70, impaired renal function, or low body mass

Question 19

temporarily reduces eGFR tp upto 15%?

Answer 19

SGLT-2i

Question 20

temporarily increases serum creatinine by 30%?

Answer 20

ACEi

Question 21

shows mortality and morbidity benefits without hospitalization improvement?

Answer 21

omega-3