heart failure

Question 1

HFpEF aka?

Answer 1

diastolic HF, PSF

Question 2

HFpEF caused by

Answer 2

hypertrophic walls (stiffness) - LVH, HCM

Question 3

HFpEF will result in _____ left atrial pressure bc____

Answer 3

Increase; LV not filling

Question 4

Causes of HFpEF

Answer 4

1. increase afterload/pressure overload
2. myocardial thickening
3. external compression

Question 5

HFrEF aka

Answer 5

LVSD, systolic HF

Question 6

HFrEF caused by

Answer 6

DCM (Dilated), decrease inotropy (to meet demands)

Question 7

Causes of HFrEF

Answer 7

1. heart cell destruction
2. Overstressed heart muscle
3. Volume overload

Question 8

SIgns of low flow

Answer 8

decrease perfusion to:

kidney, muscle, cerebral, gut

Question 9

Signs of high L sided Pressure (increase EDV to increase SV comp)

Answer 9

Increase pulmonary venous pressure:
Dyspnea
excercise
orthopnea
paraxysmal noctural dyspnea
acute pulmonary edema

Question 10

Difference between orthopnea/paraxysmal noctural dyspnea

Answer 10

Immediate/delayed (intravascular/intersitital)

Question 11

Signs of high R sided pressure

Answer 11

increase Central venous presssure
peripheral swelling
ascites
hepatic congestion
intestinal congestions

Question 12

Precipitating factor for HF

Answer 12

high circulating volume and pressure, decrease inotropy, arrhthmia, increase metabolic demands, non-adherence with HF medication

Question 13

Causes of increase circulating volume

Answer 13

retention of Na/water

renal failure

Question 14

causes of increase pressure/afterload

Answer 14

HTN
Aortic stenosis
PE

Question 15

causes of Decrease inotropy

Answer 15

MI

Beta/ca blocker

Question 16

Causes of Arrhythmias that lead to HF

Answer 16

bradycardia

Afib

Question 17

Increased metabolic demands include

Answer 17

pregnancy, fever, infection

Question 18

Describe NYHA functional class

Answer 18

asymptomatic, mod exertion, mild, at rest

Question 19

Describe ACC/AHA HF stages

Answer 19

High risk, structural/no symp, with symp, need intervention

Question 20

Signs of low flow

Answer 20

cool extremities, tachycardia, low pulse pressure

Question 21

signs of elevated L sided filling

Answer 21

rales, hypoxia, tachypnea

Question 22

Signs of right sidded pressure elevated

Answer 22

edema
JVP = CVP = RA pressure increase
Hepatic congestion/hepatomegaly

Question 23

S3 caused by

Answer 23

Early in diastole - LV opens fast and stops

HFrEF (dialated heart)

Question 24

S4 caused by

Answer 24

atrial contraction - stiff hypertrophic LV (HFpEF)

NOT in afib

Question 25

Test for HF includes

Answer 25

CXR, BNP, EKG, Echo, swan/RH catheterization, CMP/CBC, vitals

Question 26

what is BNP and importance?

Answer 26

B-type natriuretic - from myocardium due to:
ventricular stretch, hyperadrenergic state/RAAS/activation/Ischemia
Negative predictive value

Question 27

Diuretics for HF bc

Answer 27

decrease Na/Water excretion (volume overload)
Decrease venous congestions
Decrease dyspnea/edema

Question 28

Neurohormonal antagonists (for HF_EF) includes:

Answer 28

HFrEF

ACEII, ARB

Question 29

ACEI effects

Answer 29

direct vasodilation

Decrease aldosterone activation

Question 30

ARB effects

Answer 30

vasodilation, decrease aldosterone activation

ACEI without cough

Question 31

Examples of ARB

Answer 31

spironolactone, eplerenone

Question 32

Beta blockers are class __ and includes

Answer 32

II,

Metoprolol, carvedilol, bisoprolol

Question 33

Inotrope agents

Answer 33

digoxin (Na/K exchanger)
Dobutamine (beta agonist)
Milrinone (PDE inhibitor)