Heart failure Flashcards
True or false: Pink, frothy sputum is a symptom of heart failure
TRUE - fatigue, dyspnoea, orthopnoea, nocturnal cough an weight loss are also symptoms
First line treatment for heart failure
ACE-i/ARB + beta blocker
note: this is for HF with reduce ejection fraction (EF). Not used if EF is preserved
Add on options for heart failure (4 points)
1) Ivabradine
2) Hydralazine
3) Digoxin
4) Sacubitril + Valsartan (Entresto)
True or false: The risk of heart failure is lower in men
FALSE - the risk of heart failure is higher in men, smokers and diabetic.
Risk also increases with age
True or false: Amlodipine is safe to be used in heart failure with co-morbid angina
TRUE - Rate limiting CCBs and short acting diydropyridines (nifedipine and nicardipine) should be avoided as they reduce heart contractility
Which beta blockers are licensed for heart failure
3 points
Bisoprolol
Carvedilol
Nebivolol
New York Heart Association classification:
Describe the four classes
Class 1 - no limit on physical activity
Class 2 - slight limitation but normal activity may cause symptoms
Class 3 - marked limitation and less than normal activity causes symptoms
Class 4 - symptoms present at rest
True or false:
Beta blockers can be used only in stable heart failure
TRUE
If HF is unstable or severe, beta blockers are contraindicated
Which drugs that can be used in HF do the sick day rules apply to
(3 points)
ACE-i/ARBs
Diuretics
Aldosterone antagonists
When do the sick day rules apply e.g. for patients taking ramipril
When the patient is acutely unwell and has vomiting or diarrhoea
Stop the drug until eating and drinking normally to prevent risk of AKI due to dehydration
Which drugs increase the concentration of digoxin and may therefore cause digoxin toxicity ?
(4 points)
Amiodarone
CCBs
Spironolactone
Quinine
