Heart Failure

Question 1

What is heart failure?

Answer 1

Clinical syndrome which refers to a state of reduced cardiac output

Question 2

What is the heart unable to do in someone with heart failure?

Answer 2

Unable to pump enough blood to meet the metabolic needs of the body

Question 3

What are the two forms of heart failure?

Answer 3

Reduced left ventricular ejection fraction
Preserved left ventricular ejection fraction

Question 4

How is ventricular ejection fraction measured?

Answer 4

Echocardiogram

Question 5

How is reduced LVEF defined?

Answer 5

< 35 to 40%

Question 6

What do people with reduced LVEF usually have?

Answer 6

systolic dysfunction

Question 7

What is systolic dysfunction?

Answer 7

Impaired left ventricular contraction during systole

Question 8

Which conditions cause systolic dysfunction?

Answer 8

• Ischaemic heart disease
• Dilated cardiomyopathy
• Myocarditis
• Arrhythmias

Question 9

What do people with preserved LVEF usually have?

Answer 9

diastolic dysfunction

Question 10

What is diastolic dysfunction?

Answer 10

Impaired ventricular filling during diastole
Impaired ventricular relaxation

Question 11

Which conditions cause diastolic dysfunction?

Answer 11

• Hypertrophic obstructive cardiomyopathy
• Restrictive cardiomyopathy
• Cardiac tamponade
• Constrictive pericarditis

Question 12

What is acute cardiac failure?

Answer 12

An acute exacerbation of chronic heart failure

Question 13

What are the most urgent symptoms due to?

Answer 13

Ventricular failure

Question 14

What does ventricular failure usually result in?

Answer 14

Pulmonary oedema

Question 15

What does left ventricular failure usually lead to?

Answer 15

Pulmonary oedema

Question 16

What symptoms does pulmonary oedema cause?

Answer 16

• dyspnoea
• orthopnoea
• paroxysmal nocturnal dyspnoea
• bibasal fine crackles

Question 17

What does right ventricular failure usually result in?

Answer 17

• peripheral oedema- ankle/sacral oedema
• raised jugular venous pressure
• hepatomegaly
• weight gain due to fluid retention
• anorexia (‘cardiac cachexia’)

Question 18

What type of situation is acute heart failure?

Answer 18

Life-threatening emergency.

Question 19

What is acute heart failure?

Answer 19

Sudden onset or worsening of the symptoms of heart failure.

Question 20

How can acute heart failure present?

Answer 20

With or without a background history of pre-existing heart failure.

Question 21

What is acute heart failure presenting without a past history of heart failure called?

Answer 21

De-novo AHF.

Question 22

What is acute heart failure presenting with a past history of heart failure called?

Answer 22

Decompensated AHF

Question 23

What is De Novo AHF due to?

Answer 23

Ischaemia.

Question 24

How does ischaemia result in de novo AHF?

Answer 24

It causes reduced cardiac output and therefore hypoperfusion
—Pulmonary oedema

Question 25

What are the most common precipitating causes of acute cardiac failure?

Answer 25

• Acute coronary syndrome
• Hypertensive crisis
• Acute arrhythmia
• Valvular disease

Question 26

How are patients with heart failure broadly categorised?

Answer 26

• With or without hypoperfusion
• With or without fluid congestion

Question 27

What are the main symptoms of heart failure?

Answer 27

• Breathlessness
• Reduced exercise tolerance
• Oedema
• Fatigue

Question 28

What are the main signs of heart failure?

Answer 28

• Cyanosis
• Tachycardia
• Elevated JVP
• Displaced apex beat
• bibasal crackles
• S3-heart sound

Question 29

What heart sounds may present in someone presenting with heart failure?

Answer 29

S3 heart sound
Displaced apex beat

Question 30

What does impaired left ventricular functioning cause?

Answer 30

Causes build up of blood in the left atrium
This results in blood backing into the pulmonary vessels–> pulmonary oedema