Heart failure

Question 1

What is heart failure?

Answer 1

The inability of cardiac output to meet the body’s physiological needs

Question 2

What the definition of ejection fraction?

Answer 2

stoke volume/ total volume which gives the % of blood leaving the ventricles with each contraction

Question 3

How do you calculate ejection fraction?

Answer 3

Stoke volume / total volume

Question 4

What is stroke volume?

Answer 4

The volume of blood leaving the heart with each contraction

Question 5

What is the range for normal ejection fraction?

1. 40-50%
2. > 40%
3. 50-70%

Answer 5

3. 50-70% ejection fraction

Question 6

What is the range for borderline ejection fraction?

1. 40-50%
2. > 40%
3. 50-70%

Answer 6

1. 40-50%

Question 7

What is the range for ejection fraction in HF?

1. 40-50%
2. > 40%
3. 50-70%

Answer 7

2. <40%

Question 8

What are the 2 types of HF?

Answer 8

Systolic HF

Diastolic HF

Question 9

What happens in systolic HF?

Answer 9

The ventricles are unable to pump out blood efficiently due to weakened or smaller ventricles

Question 10

What are the characteristics findings of systolic HF?

Answer 10

Low cardiac output

ejection fraction <40%

Question 11

Which sided Hf is systolic HF most likely to cause?

Answer 11

Left sided HF

Question 12

Give 3 causes of systolic HF?

Answer 12

hypertension
cardiomyopathy
Ischaemic heart disease

Question 13

What happens in diastolic HF?

Answer 13

Reduced diastolic filling due to hypertrophy and small ventricular cavity = reduced cardiac output

Question 14

What are the characteristics findings of distolic HF?

Answer 14

Low stoke volume BUT NORMAL ejection fraction

Question 15

which sided HF is IHD most likely to cause?

Answer 15

Left sided HF

Question 16

Give 5 causes of HF in general

Answer 16

Hypertension 
CAD
Cardiomyopathy 
valve disease 
endocarditis 
Cor pulmonale 
atrial fibrillation

Question 17

How does cardiomyopathy cause HF?

Answer 17

Decreased strength and thin muscle walls cause less blood to be ejected out during systole

Question 18

What are 2 changes in heart muscle are may arise due to HF?

Answer 18

Hypertrophy and cardiac dilation

Question 19

What type of HF is cor pulmonale likely to cause?

Answer 19

Right sided HF secondary to pulmonary disease

Question 20

What is a common symptom present in HF patients and why?

Answer 20

Pulmonary oedema due to fluid buildup in the lungs

Question 21

How will the lungs sound on inspiration in a patient with HF?

Answer 21

Crackles due to fluid build up in the lungs

Question 22

Give 5 symptoms a patient with HF will present with?

Answer 22

Orthopnoea 
Dyspnoea 
pitting oedema 
pulmonary oedema 
Raise JVP
Jugular venous distention 
wheezing 
fatigue/lethargy 
ascites 
tachycardia

Question 23

What is BNP and what does it indicate?

Answer 23

Brain naturetic peptide

A hormone secreted from the ventricles when that myocardium is stretched

Question 24

What is the function of BNP and why?

Answer 24

Promotes vasodilation of smooth muscle and blood vessels in aiming to reduce vascular pressure

Question 25

BNP tests are :

1. sensitive
2. specific

Answer 25

SENSITIVE

not specific

Question 26

What reading of BNP is suggestive of HF?

1. <100 pg/mL
2. <300 pg/ML
3. > 400 pg/mL

Answer 26

3. > 400 pg/mL

Question 27

What is a normal reading of BNP?

Answer 27

<100 pg/mL

Question 28

What reading of BNP would require evaluation?

Answer 28

100-400ph/mL