Heart Failure

Question 1

what is the most common type of heart failure?

Answer 1

left-sided heart failure

Question 2

what is LFH also called? (2)

Answer 2

heart failure with reduced ejection fraction (HFrEF)

systolic HF

Question 3

what is heart failure with preserved ejection fraction
(HFpEF) also called?

Answer 3

diastolic HF

Question 4

measurement, expressed as a %, of how much blood the LV pumps out with each contraction

Answer 4

ejection fraction

Question 5

what are 3 causes of HFrEF?

Answer 5

CAD
increased afterload
increased preload

Question 6

what is the pathophysiology of HFrEF?

Answer 6

systolic dysfunction due to increased resistance to flow

Question 7

what are 3 causes of HFpEF?

Answer 7

hypertensive cardiomyopathy
impaired relaxation
tachyarrhythmia

Question 8

what is the pathophysiology of HFpEF?

Answer 8

abnormal diastolic function leading to vascular congestion

Question 9

thick heart walls are a sign of _____

Answer 9

diastolic failure

Question 10

thin heart walls are a sign of _____ _____

Answer 10

systolic failure

Question 11

on physical exam, what should we expect to find in a patient with heart failure? (7)

Answer 11

pulmonary crackles/wheeze
tachypnea
hypoxia
tachycardia
S3 gallop
S2 split
jugular venous distension

Question 12

what are 4 things in our work up for a patient with suspected heart failure?

Answer 12

BNP
ECG
Chest Xray
Echo

Question 13

what is secreted from the ventricles in response to elevated LV end-diastolic pressure?

Answer 13

BNP

Question 14

what diagnostic will tell us the severity of the disease?

Answer 14

BNP

Question 15

what 4 medications are given to patient with HF? (4)

Answer 15

ARNI/ACE/ARB
beta blocker
MRA (mineralocorticoid receptor antagonist)
SGLT2 inhibitor

Question 16

what is considered the first line therapy for HF?

Answer 16

Entresto (ARNI)

Question 17

what medication for HF reduces the risk for cardiovascular death and hospitalization in patient with chronic HF?

Answer 17

entresto (ARNI)

Question 18

which medication for HF will reduce morbidity and mortality?

Answer 18

ACE inhibitor

Question 19

what 3 beta blockers are approved to treat HF?

Answer 19

bisoprolol
carvedilol
metoprolol

Question 20

which medication reduced morbidity and mortality and is considered first line for symptomatic patients with systolic HF?

Answer 20

beta blockers

Question 21

what are 2 MRAs used to reduce morbidity and mortality in patient with HF?

Answer 21

spironolactone
eplerenone

Question 22

which medication used for HF helps left ventricular remodeling that occurs in patients with diabetes and HF by reducing the load on the heart?

Answer 22

SGLT2 inhibitor (farxiga)

Question 23

what medications can help with volume overload in HF?

Answer 23

diuretics (furosemide)

Question 24

what 3 medications should be avoided in patients with HF?

Answer 24

NSAIDS
CCB
anticoagulants

Question 25

which medication is good for HF in patients with concomitant afib?

Answer 25

digoxin

Question 26

what can be used in a patient with HF + BBB or other intraventricular conduction delay?

Answer 26

cardiac resynchronization therapy (CRT)

Question 27

what is recommended to prevent sudden cardiac death, v-tach, and v-fib?

Answer 27

implantable cardioverter-defibrillator (ICD)

Question 28

what symptom in a patient is a poor prognostic sign?

Answer 28

weight loss

Question 29

acute impairment in cardiac pump function resulting in inefficient perfusion to bodily tissues; may represent a new diagnosis or worsening of preexisting chronic HF

Answer 29

acute decompensated HF

Question 30

a patient presents with congestion, S3, jugular venous distention, cool extremities, frothy/pink sputum, wheezing, rales and wheezing in lungs, and cheyne-stokes respiration. what are they likely experiencing?

Answer 30

acute decompensated HF

Question 31

what 2 diagnostics can be used in a patient for evaluate for ACS?

Answer 31

cardiac troponins ECG

Question 32

what 2 diagnostics can be used for a patient suspected of acute decompensated HF?

Answer 32

echo BNP

Question 33

what are the 2 goals of therapy for ADHF?

Answer 33

normalize ventricular filling pressures restore adequate tissue perfusion

Question 34

what are the 2 main treatments for ADHF?

Answer 34

loop diuretics vasodilators