Heart Failure

Question 1

Heart failure

Answer 1

Abnormality of cardiac structure and function

CO is inadequate for the body’s requirement

Question 2

Left heart failure (mechanism)

Answer 2

If the LV doesn’t work properly, the blood backs up and causes congestion in the pulmonary circulation

Question 3

Left heart failure (clinical features)

Answer 3

SOB
Pulmonary oedema
Orthopnoea
PND

Question 4

Right heart failure (mechanism)

Answer 4

If RV doesn’t work properly, the blood baks up into the systemic circulation
Secondary to LHF

Question 5

Right heart failure (clinical features)

Answer 5

Elevated JVP
Hepatomegaly 
Ascites
Peripheral oedema
Fatigue

Question 6

Investigations

Answer 6

Bloods
ABG
ECG
CXR
Echo - confirms diagnosis

Question 7

Acute heart failure

Answer 7

Sudden onset
Potentially life threatening
Cause: new MI, new arrhythmia

Question 8

Acute heart failure (management)

Answer 8

Sit patient up 
Oxygen 
IV furosemide
IV diamorphine
IV nitrates

Question 9

Chronic heart failure

Answer 9

Gradual onset
Compensated - well controlled
Decompensated - something happens which flies up symptoms

Question 10

Chronic heart failure (management)

Answer 10

ACEi 
B-blockers 
Diuretics - furosemide
Spironolactone
Devices: ICD, CRT
Anticoagulants