Heart failure

Question 1

Which drugs improve mortality in HF?

Answer 1

ACE inhibitors
Spironolactone
Beta-blockers
Hydralazine with nitrates (VHEFT-1)

Question 2

First line treatment for HF?

Answer 2

ACE inhibitor and a beta blocker (one drug at a time)

Question 3

Second line treatment for HF?

Answer 3

Aldosterone antagonist, angiotensin II receptor antagonist, or a hydrazine in combination with a nitrate

Question 4

Third line treatment for HF?

Answer 4

Cardiac resynch therapy or digoxin

Or ivabradine if already on significant therapy with HR >75 and left ventricular fraction <35%

Question 5

When is digoxin strongly indicated?

Answer 5

When there is AF

Question 6

What should be given for fluid overload?

Answer 6

Diuretics

Question 7

What should be offered?

Answer 7

Yearly flu vaccine

One off pneumococcal vaccine

Question 8

Presentation of hypertrophic obstructive cardiomyopathy?

Answer 8

Young, falls and loss of consciousness
Ejection systolic murmur louder with valsalva maneouvre
Deep Q with T wave abnormalities/inversion
Low BP, jerky pulse
Angina, exertion dyspnoea

Question 9

What is Brugada syndrome?

Answer 9

Cause of sudden cardiac death in young people

Question 10

What should be considered in acute heart failure unresponsive to treatments?

Answer 10

Continuous positive airway pressure