Heart Failure II - Diagnosis & Treatment continued

Question 1

ACC/AHA HF Stage A

Answer 1

At risk for HF but w/o structural HD or symptoms of HF

Question 2

ACC/AHA HF Stage B

Answer 2

Structural HD but w/o signs or symptoms of HF

Question 3

ACC/AHA HF Stage C

Answer 3

Structural HD w/ prior or current symptoms of HF

Question 4

ACC/AHA HF Stage D

Answer 4

Refractory HF requiring specialized interventions

Question 5

Drugs to use for indiv. in Stage A

Answer 5

ACEI or ARB in appropriate pts

Question 6

Drugs to use for indiv. in Stage B

Answer 6

ACEI or ARB or Beta-blockers in appropriate pts

Question 7

Drugs to use for indiv. in Stage C

Answer 7

ACEI or Beta-blockers

Diuretics for fluid retention

Question 8

NYHA Functional class:
Describe 
Class I
Class II
Class III
Class IV

Answer 8

Class I: asymptomatic
Class II: symptomatic with moderate exertion
Class III: symptomatic with minimal exertion
- ie: walking up stairs
Class IV: symptomatic at rest

Question 9

What can you use for Cardiac resynchronization therapy and what do they cause?

Answer 9

Biventricular pacemakers (CRT or BiV)
- Cause the LV lateral wall and septal wall to contract together, and cause a more efficient contraction/ increase stroke volume

Question 10

If a patient is cold and wet what should you do to get them back to a happy level?

Answer 10

Warm = good CO
Dry = not congested

Cold wet → give them ionotrope → Warm wet → reduce congestion with diuretic → Warm and dry (happy)

Question 11

Therapy for HFpEF

Answer 11

diuretics - as inefficient as they may be for relief of symptoms due to volume overload

blood pressure control

coronary revascularization when myocardial ischemia is present

(no drugs to reduce fibrosis - trials pending)