Heart Failure - Presentation and Investigation

Question 1

Define the aetiology (cause) of heart failure

Answer 1

“A clinical syndrome comprising of dyspnoea, fatigue or fluid retention due to cardiac dysfunction, either at rest or on exertion, with accompanying neurohormonal activation.”

Question 2

Discuss the epidemiology (commoninity) of heart failure

Answer 2

Prevalence of heart failure 0.4 - 2%
Prevalence of asymptomatic LVSD 0.4 - 2%

Prevalence and incidence increase with age (mean age 74years)

High morbidity and mortality

PREVALENCE IS INCREASING

Question 3

What is the prognosis (outcome/course) of heart failure

Answer 3

• High morbidity and mortality

Question 4

Describe the clinical presentation of heart failure

Answer 4

SYMPTOMS:
- Breathlessness
- Fatigue
- Odema
- Reduced exercise capacity

SIGNS:
- Odema
- Tachycardia
- raised JVP
- chest crepitations or effusions
- 3rd heart sound
- Displaced or abnormal apex beat

Question 5

What are the relevant investigations of heart failure

Answer 5

• CXR
• Echocardiogram
• ECG
• BNP!!!! ( low BNP = no heart failure, LSVD elevated BNP = need echo/cardiac assessment)
• coronary angiogram?
• CMRI

Question 6

What is the treatment options for heart failure and evidence for their use

Answer 6

• Diuretics
• ACE inhibitors
• Betablockers
• Aldosterone receptor blockers
• ARNI