Heart Failure

Question 1

Management of HFrEF?

Answer 1

1st line= ACEI + BB
2nd line= Spironolactone (aldosterone antagonsit)
+ SGLT-2 inhibitor (Dapagliflozin)

4th:
-Ivabradine (HR>75 + EF<35%)
-Subcubitril valsartan
-Digoxin (for patients with AF)
-Hydralazine + nitrate (good for afro carribean)
-Cardiac resynchronisation therapy (widened QRS)

Question 2

what drugs prolong survival in HF?

Answer 2

-ACEI/ ARBs
-Bisoprolol
-Alcdosterone anatagonists (spironolactone +epleronone)
-Vasodilators (hydralazine + nitrates)
-SGLT2 inhibitors (dapagliflozin)
-sinus node blockers

Question 3

drugs that improve symptoms of HF?

Answer 3

digoxin + furesomide

Question 4

lifestyle advice for someone with HF?

Answer 4

-water + salt restriction
-regular exercise
-keep up to date with vaccinations

!! offer annual influenza vaccine !!

Question 5

management of HFpEF?

Answer 5

Manage the underlying cause (no proof medication helps the HF)

Question 6

what is HfREF

Answer 6

HfREf is when EF =/<40%
Ventricles affected during SYSTOLE (cannot properly eject blood)

Ejection fraction= percent of blood squeezed out the left ventricle with each ventricular contraction (normal >50%)

Question 7

what is HfPEF?

Answer 7

HR preserved EF is when EF>40%
LV doesn’t properly relax during DIASTOLE

Ejection fraction= percent of blood squeezed out the left ventricle with each ventricular contraction (normal >50%)

Question 8

management if If new BP >= 180/120 mmHg + new-onset signs of heart failure

Answer 8

admit for specialist treatment

If new BP >= 180/120 mmHg + new-onset confusion, chest pain, signs of heart failure, or acute kidney injury then admit for specialist assessment