Heart Failure

Question 1

What is heart failure?

Answer 1

Impaired heart function, specifically the function of the left ventricle to pump blood out of the heart and around the body.

Question 2

Name 5 causes of heart failure?

Answer 2

Ischaemic HD
Valvular HD
Arrhythmias
Cardiomyopathy
Hypertension

Question 3

Key Presentation of Heart Failure

Answer 3

Peripheral Oedema
Breathlessness
Paroxysmal Nocturnal Dyspnoea
Cough
Orthopnoea
Fatigue
Peripheral Oedema
Increased JVP
Bibasal Lung Crackles = Pulmonary Oedema

Question 4

Name some tests for Heart Failure

Answer 4

Pro BNP
Bloods: Lipids, Thyroid, FBC for Anaemia, Liver, Diabetes
CXR and Lung Function
ECG and Echo

Question 5

Pro BNP Levels for Echo

Answer 5

400-2000: Echo in 6 Weeks
2000 > : Echo in 2 Weeks

Question 6

What is the NY Heart Association Severity?

Answer 6

1: No limit
2: comfort at rest but symp with activity
3: comfort at rest but symptoms with any activity
4: symptoms at rest

Question 7

How to Treat Heart Failure Initially

Answer 7

A: Ace Inhibitor eg Ramipiril or ARB eg Candersartan
B: Beta Blocker eg Bisoprolol
A: Aldosterone Antagonist eg Spiro or Eplereonone
L: Loop Diuretic eg Furosemide or Bumetonide

Question 8

What can Ace Inhibitors and Aldosterone Antagonists cause?

Answer 8

Hyperkalaemia

Question 9

What additional drugs can be used in Heart Failure?

Answer 9

SGTL2 Inhibitor eg Dapagliflozin
Entresto
Ivabradine
Digoxin