Heart Failure

Question 1

What is meant by heart failure

Answer 1

SOB, persistent coughing or wheeze, ankle swelling, reduced exercise tolerance and fatigue

Question 2

What re the 2 different types of heart failure

Answer 2

Compensated and non compensated

Question 3

What is the first line treatment for heart failure

Answer 3

Ace inhibitor and a beta blocker as first line treatment
- initiated at low dose and slowly tired up the maximum tolerated dose
-give ARB if ace is not tolerated
- give hydralazine + nitrate if both ACE-i and b-blocker aren’t tolerated

Question 4

What do you add if symptoms persists

Answer 4

Add aldosterone antagonist such as spiral acetone or Eplerenone

Question 5

What do you add if symptoms still persists even after adding a aldosterone antagonist

Answer 5

Add amiodarone, digoxin, sac +val, ivabradien or dapagliflozin
- digoxin is for patients in sinus rhythm in worsening or severe heart failure

Question 6

How do you relieve the symptoms of breathlessness and oedema in fluid retention

Answer 6

Add loop diuretics

Question 7

What is the digoxin loading dose in heart failure

Answer 7

62.5-125mcg OD

Question 8

Which arbs are used in HF

Answer 8

Candessartan
Valsartan
Losartan

Question 9

Which beta blockers can be used in heart failure

Answer 9

Bisoprolol
Carvedilol
Nebivolol ( elderly: mild-moderate HF patients in aged 70+