Heart Failure

Question 1

Causes of heart failure?

Answer 1

Pump failure: IHD, cardiomyopathy
Excessive preload: fluid overload (RF, IV fluids), regurgitant valve disease
Excessive after load: HTN, AS
Secondary to chronic lung disease e.g. Cor pulmonale
High output failure: anaemia, pregnancy, hyperthyroid

Question 2

Define HF

Answer 2

Inability of the heart to meet the metabolic demands of the body

Question 3

Causes of heart failure?

Answer 3

Ischaemia heart disease
HTN
Valve disease 
ETOH
Idiopathic

Question 4

What classification system is used for HF?

Answer 4

NYHA
1- no limitation to physical activity
4- symptoms at rest

Question 5

Causes RVF?

Answer 5

LVF
RV infarct
lung pathology- pulmonary HTN, PE

Question 6

Signs RHF

Answer 6

Raised JVP
Abdo signs
Peripheral oedema

Question 7

Signs LHF

Answer 7

Pulmonary oedema

Displaced apex

Question 8

Mx HF?

Answer 8

Address RFs; Na restriction, avoid excessive fluids, mx dm HTN etc
Avoid CCBs
Prognostic: ACEi/ARBs, B-blockers, aldosterone antagonists in late stage
Symptomatic: Diuretics