Heart failure

Question 1

heart failure definition

Answer 1

Complex clinical syndrome resulting from any structural or functional impairment of ventricular Unable to meet metabolic tissue requirements or cannot fill completely
or ejection of blood

Question 2

HF w/ reduced EF (HFrEF)

Answer 2

EF ≤ 40%

pumping problem

Question 3

HF w/ preserved EF (HFpEF)

Answer 3

EF ≥ 50%

Question 4

Borderline hf

Answer 4

41%-49%

Question 5

improved hf

Answer 5

> 40%

Question 6

LV Diastolic Dysfunction

Answer 6

Delayed LV relaxation
Increased myocardial stiffness
Reduction in LV compliance
Restricted LV filling
LA HTN, LA systolic and diastolic dysfunction, pulmonary venous congestion, and exercise intolerance

Question 7

LV systolic dysfunction

Answer 7

Contractility is reduced
Reduced SV
Increased LV end-systolic volume and end-diastolic volume
Compensatory LV dilation
Increased LV end diastolic pressure
Pulmonary venous congestion.

Question 8

the hallmark of chronic LV systolic dysfunction

Answer 8

decreased ef < 40%

Question 9

Class 1 diastolic hf

Answer 9

Class I - abnormal LV relaxation pattern with normal left atrial pressure

Question 10

Class 2,3,4 diastolic hf

Answer 10

abnormal relaxation and reduced LV compliance resulting in an increase in LVEDP

Question 11

Acute Decompensated HF

Answer 11

Worsening symptoms of preexisting condition

Question 12

de novo acute HF

Answer 12

Sudden increase in intracardiac filling pressures and/or acute myocardial dysfunction

Question 13

Chronic Heart Failure

Answer 13

Present in pts withlong-standingcardiac disease
Accompanied by venous congestion, but BP is maintained

Question 14

Frank-starling relationship

Answer 14

SV is directly related to LVEDP
Magnitude of the increase in SV produced by changing the tension of ventricularmuscle fibers depends on myocardial contractility

Question 15

Inotropic state

Answer 15

• myocardial contractility as reflected by the velocity of contraction developed by cardiac muscle

Question 16

Afterload

Answer 16

• tension the ventricular muscle must develop to open the aortic or pulmonic valve

Question 17

Systolic HF and low CO causes SV to be …..

Answer 17

SV is fixed

Question 18

Diastolic HF HR

Answer 18

Tachycardia leads to decreased CO

Question 19

ANP

Answer 19

ANP stored in atrial muscle and released in increases in Atrial pressures

Question 20

BNP

Answer 20

BNP secreted by the atrial and ventricular myocardium

Question 21

ANP and BNP inhibit….

Answer 21

ANP and BNP inhibit cardiac hypertrophy and fibrosis

Question 22

earliest subjective finding of CHF

Answer 22

dyspnea

Question 23

concentric hypertrophy

Answer 23

pressure overload = thickened wall

Question 24

Early Cxray sign of LV fialure

Answer 24

Distention of the pulmonary veins in the upper lobes

Question 25

Gold standard to Diagnose HF

Answer 25

TEE dx synmtoms pHF > 50% LVED dysfunction

Question 26

Kerley lines

Answer 26

A- upper B = middle C = = lower lobes

Question 27

BNP that correlates with HF diagnosis

Answer 27

BNP levels > 500 pg/mL – HF diagnosis (90% positive predictive value) 300 pg/mL - detecting dyspnea of cardiac origin

Question 28

Labs that represent cardiac inflammatory factors

Answer 28

C-reactive proteins Growth differentiation factor 15

Question 29

Class 1 HF

Answer 29

no S/s

Question 30

Class 2 hf

Answer 30

slight limitations with physical acitivty

Question 31

Class 3 HF

Answer 31

marked limitation of physical activity

Question 32

Class 4 HF

Answer 32

pt is unable to perform physical acitvity

Question 33

Class A HF

Answer 33

no evidence of cv dz

Question 34

Class B HF

Answer 34

Evidence of minimal structural cv dz

Question 35

Class C HF

Answer 35

Evidence of moderately severe structural c dz

Question 36

Class D HF

Answer 36

Objective evidence of severe structural cv dz

Question 37

Diuretics for HF

Answer 37

Thiazide and Loop First-line therapy for patients presenting in acute heart failure

Question 38

Cardiac resynchronization therapy recommended for....

Answer 38

NYHA class III or IV LVEF < 35% QRS duration of 120–150 milliseconds

Question 39

IABP causes....

Answer 39

Increases aortic diastolic blood pressure and coronary perfusion pressure Enhances LV ejection