Heart Failure - Ix + Mx priniciples

Question 1

Ix
Bloods - 5 (1 only in acute failure)
? - a normal level excludes heart failure, so a good screen for ? in general practise
-CXR - ? and pulmonary ?
-ECG - for signs of ?, HTN or ?
-Echo - if ? or ? are abnormal, gold standard for Dx - EF % is diagnostic

Answer 1

FBC, U+E, LFT, TFT, acute=trop
bnp
SOB
cardiomegaly
oedema
ischaemia
arrhythmias
ECG or BNP
45%

Question 2

Further Ix may be cardiac ?, cardiac ? (to measure pressures) or ? testing (stress mri/?)

Answer 2

MRI
catheterization
functional
echo

Question 3

With a confirmed Dx of LV dysfx:

• ? advice
• ? + ? first line
• ? if Sxatic oedema
• second line: ?/ATRA/hydralazine plus ?
• third line is ?

Answer 3

lifestyle
ACEi
BB
diuretic
spironolactone
nitrates
digoxin

Question 4

First line drug mgmt
-? introduced first, with ? introduced when ?

Vaccination: against ? disease and ?
Sex: should not take ?/? as it may cause hypotension

Answer 4

ACEi
BB
stable

pneumococcal
influenza

viagra
sildenafil

Question 5

Lifestyle advice

• ? control, ? and ? restriction in severe heart failure) and ? cessation
• ? exercise should be avoided, low level ? activity is recommended
• ? ? important following an exacerbation

Answer 5

obesity
salt
fluid
smx
strenuous
endurance
bed rest