Heart Failure

Question 1

Signs and symptoms of CCF are due to ___

Answer 1

fluid retention

Question 2

Causes of LHF =

Answer 2

ischaemic heart disease (post-MI scarring)
cardiomyopathy (if HF in young)
valvular disease

Question 3

symptoms and signs of LHF =

Answer 3

SOB, orthopnoea, PND, pulm oedema (pink and frothy), tachycardia, fine creps, gallop rhythm (S3 + tachy), pleural effusion

Question 4

CXR findings of LHF:

Answer 4

cardiomegaly, bats wings esp. in lower zones, interstitial fluids

Question 5

CXR in RHF:

Answer 5

normal - fluid in venous system

Question 6

Causes of RHF:

Answer 6

2ndry to LHF, cor pulmonale (pulmonary hypertension), congenital heart disease

Question 7

Signs in RHF:

Answer 7

peripheral oedema, JVP >4cm, hepatomegaly, ascites

Question 8

Treatment in acute LVF:

4 steps

Answer 8

1) sit up - fluid moves
2) O2
3) IV ferusemide
4) IV diamorphine (not in COPD)

Question 9

Treatment for mild HF:

Answer 9

thiazide diuretics

Question 10

Main Pharmacological Treatments for HF:

Answer 10

diuretics - thiazide + loop
ACEI
β-blockers - only for chronic
spironolactone - for severe

Question 11

Drug used in HF to decrease HR if high w β-blocker use

Answer 11

ivabradine

Question 12

Drug used in HF with AF

Answer 12

digoxin

Question 13

If CCF and prolonged QRS

Answer 13

CRT/ICD

Question 14

ARB + neprilysin inhibitor may replace ACEI in mod-> severe CCF

Answer 14

Sacubitril valsartan

Question 15

Pulsus alternans

Answer 15

Left ventricular failure