Heart Failure

Question 1

Preload

Afterload

Answer 1

Preload: the initial stretching of the heart muscle prior to contraction
Afterload: the pressure which the heart contracts to eject blood

Question 2

Systolic Failure

Diastolic Failure

Answer 2

Decreased contractility

Decreased filling

Question 3

Normal EF?

Answer 3

55-70%

Question 4

MCC CHF

Answer 4

coronary artery disease

Question 5

MC type of HF

Answer 5

Systolic Failure - most common – Hallmark finding: Decrease in left ventricular ejection fraction < 40%

Question 6

how to dx diastolic HF?

Answer 6

presence of Pulmonary congestion, Pulmonary HTN and Ventricular hypertrophy

Question 7

mixed systolic and diastolic HF

Answer 7

Dilated Cardiomyopathy

High Pulmonary Pressures

Question 8

early clinical signs of CHF

Answer 8

Increase in Respiratory rate

Decrease in PaO2  Hypoxia

Question 9

late clinical signs of CHF

Answer 9

Tachypnea

Respiratory Acidosis

Question 10

cor pulmonale

Answer 10

Right sided Heart Failure without Left sided Heart Failure, typically caused by chronic lung disease

Question 11

stages of HF

Answer 11

1-at risk for HF w/o structural heart disease/symptoms
2-structural heart disease w/o symptoms
3-structural heart disease w/prior or current heart failure symptoms
4-refractory HF requiring special interventions

Question 12

stage 1 HF mgmt

Answer 12

BP/DM/lipid/weight control

afib mgmt

Question 13

stage 2 HF mgmt

Answer 13

ACE/ARB
add a B blocker
spironolactone

Question 14

stage 3 HF mgmt

Answer 14

diuretics

ARNI for HF<40%

Question 15

clinical findings for stage D

Answer 15

Repeat hospitalizations: >2 in less than 1 year
Renal Failure deterioration: rise in BUN/Cr.
Weight loss
Hypotension: intolerance to ACEI/BB
Worsening dyspnea
Increase need for Diuretics