Heart failure: Causes, Mechanism and symptoms

Question 1

HF is a clinical syndrome characterized by typical symptoms (e.g. breathlessness, ankle swelling and fatigue) that may be accompanied by signs (e.g. ____________,___________, and ______________ ) caused by a structural and/or functional cardiac abnormality, resulting in a reduced cardiac output and/or elevated intracardiac pressures at rest or during stress.

Answer 1

elevated jugular venous pressure, pulmonary crackles and peripheral oedema

Question 2

heart failure is not a _________________ but a ______________

Answer 2

disease entity

clinical syndrome.

Question 3

Approximately, __________ adults have HF worldwide

Answer 3

26million

Question 4

Heart failure

• High mortality: ~_____% of chronic HF patients will be dead by ____ years post diagnosis.
• Mode of death usually ___________ death due to ______________ or ___________

Answer 4

50; 5

sudden cardiac

progressive pump failure or arrhythmias.

Question 5

Three Main Determinants of Myocardial Mechanical Performance:

List them

Answer 5

• The Loading Conditions (Preload and)
  -The Contractile State
  -The Heart rate

Question 6

What is Preload

What is Afterload

Answer 6

Preload: Load present before contraction has started i.e. at the end of diastole.

• Afterload: The systolic load on the heart after it has started to contract.

Question 7

_________ is often the final common pathway of many CVS diseases.

Answer 7

HF

Question 8

In Nigeria and SSA, ____________ is the commonest cause of heat failure in about 70% of cases

Answer 8

Hypertension

Question 9

The pathomechanism of HF is sustained by complex inter-play of five main neurohumoral pathways:
• ________________ System
• The _________________
• The ______________ Pathway
• The _____________________ Pathway
• The ________________ (Na+Glucoseco-transporter2)

Answer 9

SympatheticNervous

AngiotensinII; Aldosterone

Neprilysin/natriuretic peptide

SGLT2Pathway

Question 10

________ system counteract the deleterious effects of SNS and RAAS

Answer 10

NP

Question 11

Effect of Natriuretic peptide system activation
• BNP and ANP
• Causes vaso________

Answer 11

dilation

Question 12

Common Signs of heart failure

List 4 more specific ones

Answer 12

Elevated jugular venous pressure

Hepatojugular Reflux

Third Heart Sound (Gallop rhythm)

Laterally displaced Apical Impulse

Question 13

Common Precipitants of Decompensation in Heart Failure

List 8🌚🌚🌚

Answer 13

• Infections eg chest infection.
• Electrolytes imbalance
• Undue Stress
• Arrthymmias
• High blood pressure
• Dehydration
• Non adherence to therapy • High salt diet

Question 14

Types of heart failure (Heart Failure Phenotypes)
1. Based ________________
2. Mode of onset: _______ or _______
3. Affected Chamber: _______,______, or __________
4. Based on ______________

Answer 14

Left Ventricular Ejection Fraction

Acute or chronic

Left, right or biventricular

haemodynamics

Question 15

Heart Failure Phenotype based on LVEF

1. Heart failure with ________ ejection fraction (HFrEF): EF ≤________%
2. Heart failure with ___________ EF (HFimpEF)
3. Heart failure with mid range ( _________ reduced) ejection fraction (HFmrEF): EF ________%
4. Heart failure with _____________ ejection fraction (HFpEF): EF ≥ ______%

Answer 15

reduced; 40

improved

mildly; 41 – 49

preserved; 50