Heart Failure

Question 1

what is heart failure?

Answer 1

output of the heart is incapable of meeting the demands of the body/tissues

Question 2

what types of heart failure are there?

Answer 2

• left heart failure

- right heart failure

Question 3

what is meant by high output failure?

Answer 3

demands of the system have increased beyond the capacity of the pump (least common)

Question 4

examples of conditions that may cause high output heart failure?

Answer 4

• anaemia

- thyrotoxicosis

Question 5

what is meant by low output heart failure?

Answer 5

pump is failing and not strong enough to force liquid around the body (most common)

Question 6

examples of conditions that may cause low output heart failure?

Answer 6

• myocardial infarction

- valve disease

Question 7

what is it called when both sides of the heart are failing?

Answer 7

congestive heart failure

Question 8

what is meant by systolic dysfunction?

Answer 8

• ventricles are enlarged
• these enlarged ventricles fill with blood
• the ventricles pump out less that 40%-50% of the blood

Question 9

what is meant by diastolic dysfunction?

Answer 9

• ventricles are stiff
• the stiff ventricles fill with less blood than normal
• the ventricles pump out about 60% of the blood (but the amount is still lower)

Question 10

what are the most common aetiologies of low output failure?

Answer 10

• heart muscle disease
• pressure overload
• volume overload
  (arrythmias and drugs also)

Question 11

examples of problems that may cause pressure overload of the heart?

Answer 11

• hypertension

- aortic stenosis

Question 12

symptoms and signs of left heart failure?

Answer 12

• dyspnoea (laboured breathing)
• tachycardia (rapid heart rate)
• low BP
• low pulse volume

Question 13

what occurs to the lungs in a patient suffering from left heart failure?

Answer 13

the lungs accumulate more blood than normal

Question 14

what are symptoms and signs of right heart failure?

Answer 14

• swollen ankles
• ascites
• raised JVP (jugular venous pressure)
• tender enlarged liver
• poor GI absorption

Question 15

what is ascites?

Answer 15

fluid buildup within the abdominal cavity

Question 16

what is fluid accumulation in superficial tissues (that can be squeezed out of the way by pressure) known as?

Answer 16

pitting oedema

Question 17

what can pitting oedema tell you about the severity of heart failure in a patient?

Answer 17

the higher up the pitting occurs, the worse the heart failure:
- thigh>calf>ankle

Question 18

how is acute heart failure treated?

Answer 18

• emergency hospital management
• oxygen
• morphine
• frusemide

Question 19

how is chronic heart failure treated?

Answer 19

community based treatment:

• improve myocardial function
• reduce ‘compensation’ effects
• where possible treat the cause

Question 20

how does acute heart failure present?

Answer 20

• acutely short of breath
• raised fluid pressure in lungs
• fluid moves into lung alveoli and gas exchange is not possible

Question 21

what underlying causes may contribute to heart failure?

Answer 21

• hypertension
• anaemia
• thyroid disease
• valve disease
• arrythmias

Question 22

what drugs may be used to treat heart failure?

Answer 22

• diuretics
• ACE inhibitors
• nitrates
• Inotropes

Question 23

what is the function of diuretics?

Answer 23

increase salt and water loss

Question 24

what is the function of ACE inhibitors?

Answer 24

reduce salt/water retention

Question 25

what is the function of nitrates in treating a patient with heart failure?

Answer 25

reduce venous filling pressure

Question 26

what drugs may make heart failure worse?

Answer 26

beta blockers