Heart Failure

Question 1

Define HF

Answer 1

Any pathological process which damages the pumping of the heart

Question 2

What causes Left sided HF?

Answer 2

IHD e.g. MI
Cardiomyopathy
Valve disease

Question 3

What cause right sided HF?

Answer 3

2nd to LHF
Congenital abnormality
Cor Pulmonale

Question 4

Signs of LHF

Answer 4

Tachycardia
Fine crepitations
Pleural effusion
3rd heart sound

Question 5

Symptoms of LHF

Answer 5

Orthopnoea
PND
Dyspnoea
Pulmonary oedema = pink frothy sputum

Question 6

Signs of RHF

Answer 6

Elevated JVP

Hepatomegaly or ascites

Question 7

Symptoms of RHF

Answer 7

Oedema of ankles or sacrum

Question 8

Treatment for HF due to cor pulmonary?

Answer 8

Oxygen and diuretic

Question 9

Treatment for HF due to valve disease?

Answer 9

Valve replacement

Question 10

Treatment for HF in AF?

Answer 10

Digoxin or DC shock

Question 11

General treatment for HF

Answer 11

Diuretic
B-blocker
ACE Inhibitor 
Spironolactone (if severe)
Nitrates

Question 12

When should digoxin not be used?

Answer 12

In NSR

Question 13

Which diuretics are used?

Answer 13

Mild = thiazide e.g. bendroflumethiazide
Severe = Loop e.g. Furosemide

Question 14

What are the side effects of ACE Inhibitors?

Answer 14

Angioneurotic oedema
Hypotension
Renal Impairment
Dry cough

Question 15

Sided effects of B-Blockers?

Answer 15

Hypotension and dyspnoea

Question 16

What is the mechanism of action of spironolactone?

Answer 16

Aldosterone receptor antagonist

Question 17

What does Ivabradine do to the HR?

Answer 17

Slows it - only use if B-blockers don’t work

Question 18

Surgical treatment for HF

Answer 18

ICD
Cardiac desynchronisation therapy
Transplant

Question 19

What are the side effects of digoxin?

Answer 19

Nausea
Vomiting
Bradycardia
Arrhythmias

Question 20

Therapy for acute LVF

Answer 20

Sit up
Give O2
IV furosemide
IV Diamorphine