Heart Failure Case ILOs

Question 1

What are the main phases of the cardiac cycle?

Answer 1

The cardiac cycle consists of diastole (ventricular filling), systole (ventricular contraction), and isovolumetric phases (no volume change).

Question 2

How do pressure changes in the heart relate to valve opening and closing?

Answer 2

When ventricular pressure exceeds atrial pressure, AV valves close; when ventricular pressure exceeds arterial pressure, semilunar valves open.

Question 3

What effect does the sympathetic nervous system have on the heart?

Answer 3

The sympathetic nervous system increases heart rate (chronotropy), contractility (inotropy), and conduction speed (dromotropy).

Question 4

What effect does the parasympathetic nervous system have on the heart?

Answer 4

The parasympathetic nervous system (via the vagus nerve) slows the heart rate and reduces the force of contraction.

Question 5

What are natriuretic peptides, and what is their role in circulation?

Answer 5

Natriuretic peptides (e.g., ANP, BNP) promote vasodilation, reduce blood volume, and decrease blood pressure by increasing sodium excretion.

Question 6

How does intracellular fluid differ from extracellular fluid?

Answer 6

Intracellular fluid is rich in potassium and proteins, while extracellular fluid contains more sodium and chloride ions.

Question 7

How does oedema form?

Answer 7

Oedema forms when fluid accumulates in the interstitial space due to increased hydrostatic pressure, reduced oncotic pressure, or impaired lymphatic drainage.

Question 7

What drives fluid movement between compartments?

Answer 7

Osmotic pressure and hydrostatic pressure drive fluid between compartments, with water moving towards areas of higher solute concentration.

Question 8

What anatomical changes occur in heart failure?

Answer 8

Heart failure leads to ventricular hypertrophy, dilation, or remodeling, depending on the type and cause of the heart failure.

Question 9

What is the pathophysiology of heart failure?

Answer 9

Heart failure occurs when the heart cannot pump efficiently, leading to reduced cardiac output, fluid retention, and increased pressure in the heart and lungs.

Question 10

What causes heart murmurs anatomically?

Answer 10

Heart murmurs result from turbulent blood flow due to valve abnormalities like stenosis or regurgitation, or structural defects like septal defects.

Question 10

What are the common signs and symptoms of heart failure?

Answer 10

Symptoms include shortness of breath, fatigue, ankle swelling, and signs like jugular venous distension and pulmonary crackles.

Question 11

What are common causes of heart failure in the UK?

Answer 11

Common causes include coronary artery disease, hypertension, valvular disease, and cardiomyopathies.

Question 12

What are key investigations for diagnosing heart failure?

Answer 12

Investigations include chest X-ray, ECG, BNP levels, and echocardiography to assess cardiac function and structure.

Question 13

What is the role of echocardiography in heart failure diagnosis?

Answer 13

Echocardiography assesses heart size, function, ejection fraction, and valve function, helping to confirm heart failure and its cause.

Question 14

What are the main principles of heart failure management?

Answer 14

Management includes lifestyle modification, medications (ACE inhibitors, beta-blockers, diuretics), and, in severe cases, devices or surgery.

Question 15

How do ACE inhibitors help in heart failure?

Answer 15

ACE inhibitors reduce afterload and preload by blocking the formation of angiotensin II, lowering blood pressure and preventing fluid retention.

Question 16

What are common side effects of ACE inhibitors?

Answer 16

Side effects include cough, hyperkalemia, hypotension, and renal impairment.

Question 17

How do beta-blockers treat heart failure?

Answer 17

Beta-blockers reduce heart rate and myocardial oxygen demand, improve ventricular filling, and slow disease progression in heart failure.

Question 18

How do SGLT2 inhibitors benefit heart failure patients?

Answer 18

SGLT2 inhibitors (e.g., dapagliflozin) reduce glucose and sodium reabsorption in the kidneys, leading to lower blood volume and reduced heart workload.

Question 19

What are aldosterone antagonists and how do they work in heart failure?

Answer 19

Aldosterone antagonists (e.g., spironolactone) reduce fluid retention by blocking aldosterone, which promotes sodium excretion and potassium retention.

Question 20

What is the role of loop diuretics in heart failure?

Answer 20

Loop diuretics (e.g., furosemide) reduce fluid overload by increasing urine output, relieving symptoms like pulmonary and peripheral oedema.

Question 21

What are side effects of loop diuretics?

Answer 21

Side effects include hypokalemia, dehydration, hypotension, and electrolyte imbalances.

Question 22

Describe the normal development of the heart in utero.

Answer 22

he heart forms from a single tube that folds and partitions into four chambers, with the septa and valves developing during weeks 4-7 of gestation.

Question 23

What congenital heart defects can arise from abnormal heart development?

Answer 23

Defects include atrial septal defects (ASD), ventricular septal defects (VSD), tetralogy of Fallot, and transposition of the great arteries.

Question 24

How do health inequalities impact cardiovascular disease risk?

Answer 24

Health inequalities, including poor access to healthcare, unhealthy lifestyle choices, and socioeconomic factors, contribute to higher rates of cardiovascular disease in disadvantaged populations.

Question 25

What is the societal impact of heart failure?

Answer 25

Heart failure imposes a significant societal burden through healthcare costs, lost productivity, and the need for long-term care and support.

Question 26

What are the differences in responses to acute illness vs. long-term conditions?

Answer 26

Acute illness often requires immediate, short-term interventions, while long-term conditions require chronic management, lifestyle changes, and ongoing support.

Question 27

What is the Frank-Starling law in relation to heart function?

Answer 27

The Frank-Starling law states that the stroke volume of the heart increases in response to increased venous return, up to a certain point, by stretching the ventricular walls.

Question 28

How do preload and afterload affect heart failure?

Answer 28

In heart failure, increased preload (due to fluid retention) and increased afterload (due to high blood pressure) worsen cardiac function by increasing the workload on the heart.