Heart Failure

Question 1

Define ‘heart failure’

Answer 1

A state in which the heart fails to maintain an adequate filling pressure
Failure of the heart to pump blood at a rate commensurate with requirements of the metabolising tissues

Question 2

Define the terms ‘preload’ and ‘afterload’

Answer 2

Preload - end diastolic stretch

Afterload - end systolic pressure, aortic pressure

Question 3

Define the compensatory mechanisms that attempt to limit the effects of heart failure

Answer 3

Sympathetic nervous system - vasoconstriction, increase heart rate
RAAS - vasoconstriction, aldosterone release, sodium and water retention, thirst stimulation

Question 4

Explain why patients with heart failure may develop systemic oedema, pulmonary oedema and dyspnoea

Answer 4

Imbalance of forces –> fluid accumulates in body and lungs

Question 5

Explain, from a physiological standpoint, the actions of anti-sympathetic drugs, diuretics and ACE inhibitor in the treatment of heart failure

Answer 5

Reduce fluid
Slow heart rate - increase filling time
Prevent RAAS

Question 6

List management options in heart failure

Answer 6

Lifestyle modification
Pharmacological - diuretics, ACEi/ARB, B blockers, spironolactone
Cardiac surgery - heart transplant, mechanical assist devises
Implantable pacemakers/defibrillators

Question 7

Define the terms ‘systolic’ and ‘diastolic heart failure’

Answer 7

Systolic HF - failure of LV to pump effectively

Diastolic HF - impaired myocardial relaxation and diastolic LV filling