Heart Failure

Question 1

Define Heart failure

Answer 1

Inability of cardiac output to meet the physiological demands of the body

Question 2

What are the 3 types of heart failure?

Answer 2

Left ventricular failure,
Right ventricular failure,
Low output and high output heart failure

Question 3

Symptoms characteristic of left ventricular failure? (3)

Answer 3

Paroxysmal nocturnal dyspnoea,
Wheeze,
Nocturnal cough with pink sputum

Question 4

Symptoms characteristic of right ventricular failure? (2)

Answer 4

Peripheral oedema,
ascites,
(usually cased by LVF or lung disease)

Question 5

Causes of heart failure? (9)

Answer 5

Endocrine disorders, 
Cor pulmonale, 
Coronary artery disease 
Hypertension, 
AF, 
Valve disease, 
Cardiomyopathies, 
Infective endocarditis,
Anaemia

Question 6

Classifications used for heart failure? (2)

Answer 6

Framingham Criteria,

New York Heart Association

Question 7

Framingham Heart failure criteria

Answer 7

2 major criteria or 1 major + 2 minor

Major:
paroxysmal nocturnal dyspnoea, 
Acute pulmonary oedema, 
Increased heart size, 
Increased central venous pressure,
Neck vein dilation, 
S3 gallop

Minor:
Pleural effusion, 
Ankle oedema (bilateral),
Increased heart rate >120bpm,
Nocturnal cough

Question 8

New York Heart Association classification for heart failure

Answer 8

I- No limitation of physical activity
II- Slight limitation of physical activity
III- Marked limitation of physical activity
IIII- Inability to carry out physical activity

Question 9

Investigations for heart failure? (4)

Answer 9

Bloods:
-FBC, U&Es, LFTs, TFTs, lipid profile
BNP
CXR
ECHO
ECG

Question 10

CXR presentation of heart failure? (h: ABCDE)

Answer 10

A- Alveolar oedema (bat wings)
B- kerley B lines
C-Cardiomegaly
D-Dilated upper lobe vessels
E-pleural Effusion

Question 11

Treatment of heart failure?

Answer 11

Conservative- smoking cessation, alcohol reduce, diet changes
ACEi,
Beta Blockers, 
ARB, 
Digioxin, 
Diuretics eg furosemide, 
Spironolactone, 
heart transplant

Question 12

Complications of heart failure?

Answer 12

Renal failure,
Valve dysfunction,
Stroke

Question 13

Causes of left sided heart failure? (5)

Answer 13

Coronary artery disease,
Hypertension,
Aortic valve disease,
Mitral valve disease,
Myocardial disease

Question 14

Causes of right sided heart failure? (4)

Answer 14

Left sided heart failure,
Tricuspid valve disease,
Pulmonary valve disease,
Pulmonary vascular disease