H279:1500-1516-Heart Failure

Question 1

Two types of HF

Answer 1

HF with reduced EF (systolic formerly)

HF with preserved EF (diastolic formerly)

Question 2

General break down of etiologies of HF

Answer 2

Depressed EF (40%) CAD, HTN, Valvular, Toxic, Chagas, Arrhythmias etc. 
Preserved EF (40-50%) Cardiomyopathies, Aging, Endomyocardial disorders
Highoutput States (Thyrotoxicosis,beriberi,AV shunt, Chronic Anemia)

Question 3

NYHA breakdown

Answer 3

I - exertion and ADLS = no HF Signs 
II - ordinary exertion = HF signs
III - ADLs = HF Signs
IV- Rest = HF Signs
Q: Comfortable at rest ? Signs with ordinary exertion ?

Question 4

Major causes of HF in South America, Africa, and Asia

Answer 4

Asia and Africa - RF

South America - Chagas

Question 5

Prognosis of NYHA IV

Answer 5

30-70% annual mortality rate

Question 6

3 major areas of pathogenesis in HF

Answer 6

Myocyte biology
Myocardial changes
LV chamber geometry

Question 7

5 important clinical manifestations

Answer 7

Tachypnea
Orthopnea (trepopnea)
PND
Mood changes/fatigue
Acute pulmonary edema

Question 8

4 critical areas of examination

Answer 8

JVD
Pulmonary - crackles/rales/crepitation/wheezing
Cardiac - Displaced PMI, tri regurg
Abdomen/Extremities - Pedal Edema (presacral in bedbound)

Question 9

Definition of Heart Failure

Answer 9

structural or functional impairment of filling or ejection of ventricles resulting in the signs of dyspnea, edema, fatigue and rales.