Heart Failure

Question 1

What is heart failure?

Answer 1

Cardiac output is inadequate for body’s requirements

Question 2

What are the causes of heart failure? (4)

Answer 2

Age > 65
Ischaemic heart disease
Cardiomyopathy
Obesity

Question 3

What are the 3 main symptoms of heart failure?

Answer 3

SOB
Fatigue
Oedema

Question 4

How would a typical heart failure patient present in exams?

Answer 4

Patient sleeps propped up in bed/ sat in a chair

SOB when lying down

Question 5

What are the clinical presentations of right heart failure? (4)

Answer 5

Peripheral oedema
Raised JVP
Ascites
Nausea

Question 6

What are the clinical presentations of left heart failure? (4)

Answer 6

Pulmonary oedema (crackles on chest)
Nocturnal cough + SOB
Pink frothy sputum
Wheeze

Question 7

How would you investigate heart failure? (4)

Answer 7

Bloods: raised serum BNP
ECG
CXR
Gold standard: echocardiography

Question 8

What would you see on x-ray in heart failure? (5)

Answer 8

ABCDE
Alveolar oedema (bat wings)
B-line Kerley
Cardiomegaly
Dilated upper veins
Effusion (pleural)

Question 9

How would you manage chronic heart failure? (4)

Answer 9

ABCD
ACE-i - ramipril
BB - bisoprolol (start low and go slow)
Cardiac glycosides - digoxin
Diuretics - furosemide, spironolactone

Question 10

How would you manage acute heart failure? (4)

Answer 10

LOON
Loop diuretics - furosemide
Oxygen
Opioids - diamorphine
Nitrates - GTN spray

Question 11

How would you manage heart failure surgically? (4)

Answer 11

CABG
Valve replacement
Pacemaker
Heart transplant