Heart Failure

Question 1

What is the difference between reduced and preserved ejection fraction?

Answer 1

Reduced EF = less than 40%

Preserved EF = more than 40%

Question 2

Which drugs worsen heart failure?

Answer 2

Corticosteroids
NSAIDs
Pioglitazone

Question 3

When should ACE inhibitors be started first?

Answer 3

If diabetic or fluid overload

Question 4

When should B-blockers be started first?

Answer 4

Angina

Question 5

What is the management of heart failure?

Answer 5

Loop diuretics for symptom relief
First line: ACEI and BB
Second line: Spironolactone
Third line: started by specialist: Ivabradine, Digoxin

Question 6

What is the management of acute pulmonary oedema?

Answer 6

Position upright
IV diuretics
Oxygen
Consider CPAP if not responding to treatment

Question 7

When to consider cardiac resynchronisation therapy?

Answer 7

Symptomatic despite optimal medical therapy
Wide QRS

Question 8

Which medication is indicated if there is co-existing atrial fibrilation with heart failure?

Answer 8

Digoxin

Question 9

What are the causes of raised BNP?

Answer 9

Hypoxia (PE, COPD)
Ischaemia
Sepsis

Question 10

What are the causes of decreased BNP?

Answer 10

Heart failure drugs
Obesity

Question 11

What treatment is needed in acute HF/pulmonary oedema with hypotension?

Answer 11

Inotropic support