Heart Failure

Question 1

Prevalence of heart failure

Answer 1

6 million

Question 2

_____ failure: decrease in contraction or inotropy

Answer 2

Systolic

Question 3

_____ failure: decrease in lusitropy

Answer 3

Diastolic

Question 4

_____ failure: preserved ejection fraction

Answer 4

Diastolic

Question 5

_____ failure: reduced ejection fraction

Answer 5

Systolic

Question 6

_____ failure: seen in conjunction with dilated cardiomyopathy

Answer 6

Systolic

Question 7

_____ failure: seen in conjunction with left ventricle hypertrophy or hypertrophic cardiomyopathy

Answer 7

Diastolic

Question 8

______: delayed shortness of breath that results from mobilization of edmea from tissue to bloodstream via lymphatics

Answer 8

Paroxysmal Nocturnal Dyspnea

Question 9

______: immediate shortness of breath while lying flat

Answer 9

orthopnea

Question 10

ACC/AHA Stage __: high risk for heart failure without structural disease or symptoms

Answer 10

A

Question 11

ACC/AHA Stage __: refractory heart failure requiring specialized interventions

Answer 11

D

Question 12

ACC/AHA Stage __: structural heart disease with prior or current symptoms of failure

Answer 12

C

Question 13

ACC/AHA Stage __: Structural heart disease without symptoms of failure

Answer 13

B

Question 14

Annual incidence of heart failure

Answer 14

550,000

Question 15

Causes of diastolic failure (2)

Answer 15

Myocardial thickening/fibrosis, External compression

Question 16

Causes of right-sided failure (4)

Answer 16

Left sided failure, lung disease, shunt/tricuspid regurgitation, RV myocardial damage

Question 17

Causes of systolic failure (4)

Answer 17

Myocyte destruction, Overstressed heart muscle, Volume overloaded heart muscle, High afterload

Question 18

Decrease in _______ and increase in ______ are central to heart failure pathophysiology

Answer 18

cardiac output; filling pressures

Question 19

Most common arrhythmias that precipitate heart failure

Answer 19

Bradycardia, Atrial fibrillation

Question 20

Most common causes of increased metabolic demands in HF patients (4)

Answer 20

Fever/infection, pregnancy, anemia, hyperthyroidism

Question 21

NYHA Stage __: asymptomatic

Answer 21

I

Question 22

NYHA Stage __: symptomatic at rest

Answer 22

IV

Question 23

NYHA Stage __: symptomatic with minimal exertion

Answer 23

III

Question 24

NYHA Stage __: symptomatic with moderate exertion

Answer 24

II

Question 25

Precipitants affecting afterload (3)

Answer 25

Hypertension, aortic stenosis, pulmonary embolism

Question 26

Precipitants affecting inotropy (2)

Answer 26

myocardial ischemia, negative inotropes

Question 27

Precipitants affecting preload (2)

Answer 27

Dietary salt intake, renal failure

Question 28

Precipitants of Heart Failure (6)

Answer 28

Increased circulating volume, increased pressure, arrhythmias, worsened contractility, increased metabolic demands, non-adherence to medication

Question 29

Responses to heart failure in order of increasing time scale

Answer 29

Frank-Starling, Neurohormonal (RAAS), Remodeling

Question 30

S3 is typically associated with ____ EF.

Answer 30

reduced

Question 31

S4 is typically associated with ____ EF

Answer 31

preserved

Question 32

Symptoms of decreased cardiac output (4)

Answer 32

Fatigue, Anorexia/Wasting, decreased urine output, exercise intolerance

Question 33

Symptoms of increased central venous pressures (4)

Answer 33

Peripheral Edema, Hepatic Congestion, Intestinal congestion, ascites

Question 34

Symptoms of increased pulmonary pressures (4)

Answer 34

Dyspnea, Orthopnea, Paroxysmal Nocturnal Dyspnea, Acute Pulmonary Edema

Question 35

Types of remodeling in response to HF (4)

Answer 35

Dilation, hypertrophy, myocardial fibrosis, myocardial damage/apoptosis