Heart Failure (Exam IV) Flashcards

1
Q

What ejection fraction would characterized HFrEF (heart failure with reduced ejection fraction) ?

A

≤ 40%

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2
Q

What ejection fraction would characterized HFpEF (heart failure with preserved ejection fraction) ?

A

≥ 50%

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3
Q

Which type of heart failure is characterized by reduced compliance and restricted left ventricular filling?

A

LV Diastolic Failure

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4
Q

Which type of heart failure is characterized by reduced contractility, LV dilation, pulmonary congestion, and increased ESV and EDV volumes?

A

LV Systolic Failure

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5
Q

Systolic dysfunction results in _______ ventricular systolic wall motion.

A

decreased

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6
Q

What are the four common causes of systolic heart failure?

A
  • CAD
  • Dilated Cardiomyopathy
  • Chronic ↑ Afterload (HTN, AS, etc)
  • Chronic Volume overload
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7
Q

What is the hallmark sign of Chronic LV systolic dysfunction?

A

EF ≤ 40%

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8
Q

What are common causes of Diastolic Heart Failure?

A
  • CAD
  • Chronic HTN
  • Chronic AS
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9
Q

Is systolic or diastolic heart failure age-dependent?

A

Diastolic HF

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10
Q

Which class of diastolic HF is characterized by abnormal LV relaxation but normal left atrial pressures?

A

Class I

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11
Q

Diastolic HF classes II, III, and IV are characterized by what?

A
  • Abnormal relaxation
  • ↓ LV compliance
  • ↑ LVEDP
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12
Q

What is acute decompensated HF?

A

Chronic HF that has developed to become Acute

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13
Q

What is de novo acute HF?

A

Sudden myocardial dysfunction (ex. MI)

Emergency.

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14
Q

Chronic heart failure features venous ________, but the BP is _________.

A

congestion; normal

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15
Q

Stroke volume is directly related to ________.

A

LVEDP

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16
Q

What normal physiologic mechanism contributes to the continued deterioration of chronic HF?

A

SNS activation

17
Q

Why does the RAA system get activated in chronic heart failure?

A

RAAS activated due to decreased renal blood flow

18
Q

Define afterload.

A

Pressure needed to open the semi-lunar valves.

19
Q

Will tachycardia increase or decrease CO in a patient with diastolic HF?

A

Decrease CO

20
Q

What is the endocrine response of the heart to chronic HF ?

A
  • ↑ ANP secretion from the atria
  • ↑ BNP secretion from the ventricles
21
Q

What are the physiologic effects of the natriuretic peptides?

A
  • Diuresis
  • Natriuresis
  • Vasodilation
  • Anti-inflammatory
  • RAAS & SNS inhibition
22
Q

ANP and BNP secretion inhibit what two things?

A
  • Hypertrophy
  • Fibrosis
23
Q

What type of hypertrophy is noted by 1 on the figure below?

A

Concentric Hypertrophy

24
Q

What type of hypertrophy is noted by 2 on the figure below?

A

Eccentric Hypertrophy

25
Q

What auscultated sound is indicative of heart failure?

A

S3 gallop

26
Q

What are kerley lines on a chest x-ray ?

A

Linear opacities caused by interstitial pulmonary edema

27
Q

What lab value is 90% predictive of a HF diagnosis?

A

BNP > 500 pg/mL

28
Q

Describe the NYHA heart failure classification scale.

A
29
Q

Describe the 2005 ACC/AHA heart failure classification scale.

A
30
Q

What is the Intermacs profile system?

A
31
Q

What drug classes are preferred for treatment of HFrEF ?

A
  • β-blockers
  • ACE-Inhibitors
32
Q

What drug class is useful for the control of hypertension and HFpEF?

A

ARBs

33
Q

Statins are not recommended in HFrEF patients. T/F?

A

False. Statin are recommended in all HF patients

34
Q

When is cardiac resynchronization therapy indicated?

A
  • NYHA class III or IV
  • LVEF < 35%
  • QRS duration of 120-150 ms