Heart Failure HYHO

Question 1

Diagnostic criteria for reduced ejection fraction?

Answer 1

Left ventricular ejection fraction of 40% or less

Question 2

Diagnostic criteria with preserved ejection fraction?

Answer 2

Left ventricular ejection fraction of 50% or more

Question 3

What is the predominant cause of heart failure with reduced ejection fraction?

Answer 3

Coronary artery disease- leads to left ventricular dilation

Question 4

What is the predominant cause of heart failure with preserved ejection fraction?

Answer 4

Hypertension - leads to left ventricular hypertrophy

Question 5

What are some X-ray findings you would find with someone how has heart failure?

Answer 5

Alveolar edema (bat’s wings), prominent upper lobe vessels, Kerly B lines (interstitial edema), Pleural effusion, and cardiomegaly

Question 6

What are major criteria for heart failure (Framingham criteria)?

Answer 6

Paroxysmal nocturnal dyspnea, orthopnea, elevated JVP, crepitations, third heart sound, and radiological evidence of cardiomegaly and pulmonary edema

Question 7

What is the firstline treatment for heart failure with reduced ejection fraction?

Answer 7

First line: ACE inhibitors and beta blockers, offer a mineralocorticoid receptor antagonist if sx continue

Question 8

What do you give for HFrEF if the pt is intolerant to ACE inhibitors?

Answer 8

ARBs

Question 9

What do you give a pt with HFrEF if they are intolerant to ACE inhibitors and ARBs?

Answer 9

Hydralazine and nitrate. If those don’t work

Question 10

What do you give a pt with heart failure with preserved ejection fraction?

Answer 10

Manage comorbid conditions such as HTN, A-fib, ischemic heart disease, and DM in line with NICE guidance

Question 11

What are possible somatic dysfunctions associated with CHF (parasympathetic)?

Answer 11

Increased tone = bradycardia, vagus nerve, OA, AA, C2

Question 12

What are possible somatic dysfunctions associated with CHF (sympathetic)?

Answer 12

Increased tone = tachycardia, T1-T5

Question 13

What are possible somatic dysfunctions associated with CHF (Motor)?

Answer 13

C3-C5 (phrenic nerve to the diaphragm)

Question 14

Other somatic dysfunctions possible with heart failure?

Answer 14

Dependent extremity edema, rib dysfunction, flattened diaphragm, scalene hypertonicity and tender points, pectoralis minor hypertonicity and tender points

Question 15

What is a 2 min treatment for HF?

Answer 15

Lower extremity pedal pump

Question 16

What is a 5 min treatment for HF?

Answer 16

Rib raising

Question 17

What areas can you use lymphatic techniques for HF?

Answer 17

Abdomen by doming the diaphragm, effleurage on the upper and lower extremities

Question 18

Where can you use Chapman’s point for HF?

Answer 18

On the chest/back/abd for the heart

Question 19

Where can you use ME, MFR, or FPR for HF?

Answer 19

Thoracolumbar junction, thoracic spine, rib dysfunction, cervical spine and scalenes, pectoralis minor

Question 20

What are other possible DDx associated with CHF/ADHF?

Answer 20

PE, acute asthma, pneumonia, noncardiogenic pulmonary edema (e.g. ADRS), pericardial tamponade or constriction