Final Exam - Heart Failure Flashcards
What is synonomus with HFrEF?
What EF defines it?
- Systolic HF
- EF < 40%
What is synonomus with HFpEF?
What EF defines it?
- Diastolic HF
- EF >50%
What is borderline HF?
EF betwenn 40-49%
Which HF contsists of diastolic dysfunction?
Both HFrEF and HFpEF
Why are the propotions of pts with HFpEF increasing?
- HTN
- DM
- A fib
- Obestity
- COPD
- Renal insufficiency
- Anemia
All of these are increasing
Which type of HF is likely to have more modifiable risk factos an higher incidence of serious cardiac events?
HFrEF
Which gender is more likely to have HFpEF and HFrEF?
HFpEF: Women
HFrEF: Men
Which HF requires an increasd LV filling pressure to acheive a normal EDV?
HFpEF (Diastolic dysfunction)
LV is hypertrophied, require more pressure to fill the ventricle
What does the reduction in LV compliance lead to in HFpEF?
- LA hypertension/dysfunction
- Pulmonary venous congestion
- Exercise intolerance
Remember, the stiff LV causes a increased pressures and back up of blood
What is this volume pressure curve showing?
HFrEF (systolic dysfunction)
What is this volume pressure curve showing?
HFpEF (diastolic dysfunction)
What contibutes to the LV diastolic dysfunciton in HTN patients?
Chronic high afterload causes LV hypertrophy and decreased ability to relax/fill
What is typically the first symptom when it comes to HFpEF?
Exercise intolerance
What exacerbates diastolic dysfunction and why?
Tachycardia - further reduces diastolic filling
What symptoms are more common in HFpEf and HFrEF?
HFpEF: paroxysmal nocturnal dyspena, pulmonary edema, dependent edema
HFrEF: S3 gallop
A mPAWP of ____ at rest or ____ during exercise indicates HFpEF
> 15 mmHg
25 mmHg
What CXR finding is an early sign of LV failure and pulmonary HTN?
Distention of pulmonary veins in the upper lung lobes
What CXR finding represents interlobar edema?
Kerley lines
What is included in the diagnostic criteria for HFpEF based on the ACCF/AHA?
- HF symptoms
- LV EF >50%
- Evidence of LV diastolic dysfunction
Which guidelines are more specific and incorporates more cardiac measurements?
European Society of Cardiology
EKG has a ____ predictive value for HF
low
What labs are important in HF?
What do they reflect?
Which HF would you expect them to be higher in?
- BNP, N-terminal pro BNP
- LV end-diastolic wall stress
- Higher in HFrEF; increased LV dilation
What 2 labs are elevated d/t inflammation from HF?
- C-reactive protein(CRP)
- growth differentiation factor-15(GDF15)
Difference between the NYHA and ACC/AHA HF classifications?
NYHA: focuses of degree of physical limitation
ACC/AHA: focuses on prescence and structural severity of HF
