Heart Failure- Clincal Questions

Question 1

What is the prognosis for a patient with heart failure?

Answer 1

Depends on type- 50% of people die within 4 years

Question 2

If someone has oedema in their ankles due to HF, where is the oedema likely to occur when they lie down?

Answer 2

Pulmonary oedema-lungs causing breathlessness

Sacral oedema- lower back

Question 3

What is suggested by visible jugular pulsation in the neck and how might this relate to swelling in someone’s ankles?

Answer 3

The person in question has right heart failure which is raising their jugular venous pressure (increase in systemic venous pressure)

The increase in overall venous pressure is causing the ankle oedema

Question 4

Why might someone have a forceful and left displaced apex beat?

Answer 4

They have hypertrophy of the left ventricle meaning the beat is felt most strongly on the left side of the heart

Question 5

What is congestive HF?

Answer 5

Refer specifically to the stage in which fluid builds up around the heart and causes it to pump inefficiently

Question 6

Someone has HF but there is a lack of ankle swelling and no visible jugular pulsation, what type of HF do they have?

Answer 6

Left HF

Question 7

Why does fluid collect more at the base of the lungs as opposed to the apex?

Answer 7

1. Gravity

2. Lack of cilia to encourage upward movement

Question 8

Why might someone with pulmonary oedema and Left HF be coughing up blood?

Answer 8

Oedema is causing bursting of capillaries, rupturing capillaries due to increased hydrostatic pressure