Disorders of Extracellular Fluid Volume: Heart Failure Mnemonics

Question 1

What does ‘SAD HEART’ represent in HF pathophysiology?

Answer 1

Sympathetic overdrive, ADH release, Decreased ANP/BNP, Hemodynamic overload, EABV ↓, Aldosterone ↑, Renin-angiotensin ↑, Tubular Na⁺ retention

Helps remember the neurohormonal cascade in HF.

Question 2

What are the classic signs of volume overload in HF represented by ‘JVD S³ PAP’?

Answer 2

Jugular venous distension, Volume overload, Dyspnea, S³ gallop, Pulmonary crackles, Ascites, Pitting edema

Classic signs of volume overload in HF.

Question 3

What does ‘LOOP the DOSE’ signify in diuretic therapy?

Answer 3

Low EABV → start Oral furosemide, Optimize with Oral thiazides if needed, Pump up to Parenteral if resistant, Double dose if no response, Omit NSAIDs, Salt restrict, Evaluate electrolytes daily

Stepwise approach to diuretic management.

Question 4

What are the types of Cardiorenal Syndrome (CRS) in ‘1-2-3-4-5 CARDS’?

Answer 4

1 → Acute Cardiac → AKI, 2 → Acute CKD from chronic HF, 3 → Renal AKI → cardiac dysfunction, 4 → Dialysis → HF complications, 5 → Systemic disease affecting both

Matches CRS types to their causes.

Question 5

What priorities are included in HF management as represented by ‘ABCDE’?

Answer 5

Afterload reduction (ACE-I/ARB), Beta-blockers (carvedilol), Contractility support (digoxin), Diuretics (furosemide), Euvolemia monitoring (daily weights)

Core treatment pillars for chronic HF.

Question 6

What causes of diuretic resistance are summarized by ‘RESIST’?

Answer 6

Renal hypoperfusion, Excessive Na⁺ intake, Secondary hyperaldosteronism, Inadequate dose, Secretory dysfunction (hypoalbuminemia), Tubular adaptation

Common reasons for poor diuretic response.

Question 7

What are the indications for ultrafiltration summarized in ‘FILTER’?

Answer 7

Fluid overload refractory to diuretics, Intractable edema, Low urine output, Toxins/cytokines to remove, Electrolyte imbalances, Renal dysfunction worsening

When to consider ultrafiltration.

Question 8

What key reminders for HF management are represented by ‘FAILURE’?

Answer 8

Furosemide first-line, Avoid NSAIDs, Increase doses gradually, Limit fluids if hyponatremic, Use metolazone for resistance, Restrict salt, Evaluate EABV status

Key clinical reminders for HF management.