Heart failure

Question 1

how can heart failure be classified (2 ways)

Answer 1

way 1: L HF, R HF, Mixed HF

way 2: acute or chronic

Question 2

what causes the signs and symptoms

Answer 2

fluid retention

Question 3

what is L sided HF due to

Answer 3

IHD (due to previous MI)
cardiomyopathy
valvular disease

Question 4

what is R sided HF due to

Answer 4

secondary to L HF
cor pulmonale (end stage of COPD)
congenital heart disease

Question 5

symptoms of L sided HF

Answer 5

SOB
orthopnoea (SOB lying down)
paroxysmal nocturnal dyspnoea (SOB which wakes them up)
Pulmonary oedema

Question 6

signs of L sided HF

Answer 6

tachycardia
fine crepitations
pleural effusion 
3rd HR sound 
gallop rhythm = 3rd sound + tachy

Question 7

CXR of L sided HF

Answer 7

cardiomegaly 
"bat wing shadow" = perihilar oedema
interstitial fluid 
"kerley B lines"
blunt costophrenic angles

Question 8

symptoms of R sided HF

Answer 8

oedema (ankle/sacral)

acites

Question 9

signs of R sided HF

Answer 9

Elevated JVP
hepatomegaly
ascites

Question 10

CXR of R sided HF

Answer 10

normal

Question 11

treatment of HF caused by Cor pulmonale

Answer 11

diuretics

oxygen

Question 12

treatment of HF caused by valvular disease

Answer 12

surgery

Question 13

treatment of HF caused by AF

Answer 13

digoxin

DC shock

Question 14

standard treatment of HF

Answer 14

diuretics 
ACE I
B-blockers
spironolactone (if severe)
digoxin (if AF is also present)
implantable defib
transplant

Question 15

treatment of HF caused by previous MI

Answer 15

standard treatment of HF:

diuretics 
ACE I
B-blockers
spironolactone (if severe)
digoxin 
implantable defib
transplant

Question 16

treatment of HF caused by cardiomyopathies

Answer 16

standard treatment of HF:

diuretics 
ACE I
B-blockers
spironolactone (if severe)
digoxin 
implantable defib
transplant

Question 17

what diuretic is normally used in HF

Answer 17

loop diuretic e.g. furosemide

Question 18

what diuretic is used for mild HF

Answer 18

thiazide

Question 19

acute LVF treatment

Answer 19

sit up
oxygen
IV furosemide
IV diamorphine

Question 20

what is heart failure

Answer 20

the inability of the heart to pump adequate amounts of blood to meet the body’s oxygen and nutrient needs

end stage of any heart issue

Question 21

what is systolic HF

Answer 21

inability of the heart to contract efficiently enough to pump blood around the body

Question 22

what is diastolic HF

Answer 22

reduced heart compliance, impaired ventricle filling

Question 23

what will L HF lead to

Answer 23

pulmonary congestion then fluid build up then oedema

pulmonary hypertension

RHF

Question 24

what is congestive HF

Answer 24

failure of BOTH sides of the heart

Question 25

what is acute HF

Answer 25

acute onset of HF symptoms, usually brought on by an acute event like MI

Question 26

what is chronic HF

Answer 26

slow progressive HF due to an underlying cause

Question 27

what symptoms are caused by HF of BOTH sides

Answer 27

fatigue
weight loss
wheeze
pulsus alterans = pulse varies between weak and strong

Question 28

what investigations are used for HF

Answer 28

bloods - anaemia
ECG
echo
angiograph - assess ischaemic disease
CXR
pulmonary function test

Question 29

bat wing shadow

Answer 29

L HF

Question 30

kerley B lines

Answer 30

L HF