Heart Failure

Question 1

Cardinal symptoms of HF

Answer 1

Dyspnea and Fatigue

Question 2

What is heart failure?

Answer 2

Heart failure is a complex clinical syndrome due to structural or functional impairment of ventricular filling or ejection.

Question 3

Types of Heart Failure

Answer 3

Systolic HF or HFrEF (EF<40%)
Diastolic HR or HFpEF (EF>40-50%)
High Output HF - EF initially normal then declines

Question 4

Type of HF - HYPERTENSION?

Answer 4

HFpEF

Question 5

Type of HF: Coronary Artery Disease?

Answer 5

HFrEF

CAD, Dilated CM, VHD

Question 6

Type of HF: Beriberi

Answer 6

High Output HF

B. A. T. A.
Beriberi
Anemia
Thyrotoxicosis
AV fistula

Question 7

Differentiate Left-Sided vs Right-Sided CHF symptoms

Answer 7

Left - dyspnea predominates (pulmonary edema, bilateral basilar rales, pleural effusions, orthopnea, PND)

Right - fluid retention predominates (JVD, peripheral edema, hepatomegaly, ascites)

Question 8

Differentiate Left-Sided vs Right-Sided CHF symptoms

Answer 8

Left - dyspnea predominates (pulmonary edema, bilateral basilar rales, pleural effusions, orthopnea, PND)

Right - fluid retention predominates (JVD, peripheral edema, hepatomegaly, ascites)

Question 9

NYHA Classification for HF

Answer 9

I - no limitation, can climb 2 flights of stairs with ease

II - Mild limitation, can climb 2 flights of stairs but with difficulty

III - Marked limitation, can climb <1 flight of stairs

IV - symptoms at rest

Question 10

STAGES OF HEART FAILURE

Answer 10

A - High risk for HF
B - Structural Heart Dse but no symptoms
C - Structural Heart Dse with prior or current symptoms
D - Refractory HF

Question 11

Most important diagnostic test for HF?

Answer 11

Echocardiogram

*When to answer BNP?
If patient has acute SOB in whom etilogy of dyspnea is not clear and you cannot wait for an echo to be done. A normal BNP excludes CHF as a cause of SOB.