heart failure shit 2

Question 1

signs of ↑ left-sided pressure

Answer 1

1. Rales
2. Hypoxia
3. Tachypnea
4. Sitting bolt upright

Question 2

signs of ↑ right-sided pressure

Answer 2

1. edema
   (folloing gravity in legs, sacrum, scrotum)
2. Hepativ congestion/hepatomegaly
3. JVD

Question 3

JVP =

Answer 3

CVP = right atrial filling pressure
Assumes no blockage or valve in between
Normal is < 5 cm H2O, so typically collapsed

Question 4

JVD =

Answer 4

jugular distension = ↑ CVP

Question 5

JVP: triphashic wave

Answer 5

Distinguish from carotid

Question 6

JVP: A wave

Answer 6

atrial contraction

Question 7

JVP: C wave

Answer 7

closing of the tricuspid valve early in systole

Question 8

JVP: V wave:

Answer 8

movement of the RV annulus and tricuspid valve backward at the very end of systole (before the valve opens)

Question 9

Gallop is a

Answer 9

S3, S4– extra heart sounds

Question 10

S3 can be present in

Answer 10

in normal young people; abnormal after age 40

Question 11

S3 is typical of

Answer 11

HFrEF/dilated heard

Question 12

S3 cadance

Answer 12

Ken-tuc-ky (S1, s2, s3)

Question 13

S4 is caused by

Answer 13

atria contracting forcefully in an effert to overcome an abnormally stiff or hypertrophic LV

Question 14

S4 is

Answer 14

usually abnormal
ten-ne-ssee
s4-s1-s2
absent in AFIB

Question 15

summation gallop is

Answer 15

all 4

Question 16

heart failure symptoms: typical

Answer 16

1. breathlessness
2. orthopnea
3. paroxysmal nocturnal dysnpnoea
4. reduced exercise tolerance
5. fatigue, tiredness, increased time to recover after exercise
6. ankle swelling

Question 17

HF signs: more specific

Answer 17

1. elevated JVP
2. hepatojugular reflex
3. third hear sound (gallop rhythm)
4. latteral displaced apical impulse
5. cardiac murmur

Question 18

Co-existing conditions which predispose to HF

Answer 18

1. heart disease
(coronary, valve disease, hypertension)
2. cardiac risk disorder:
(diabetes, renal failure)
3. absence of non-HF causes of dyspnea

Question 19

Natriuretic peptides (BNP)

Answer 19

B-type natriuretic is secreted by the myocardium in response to either ventricular stretch or hyperadrenergic state/RAAD activation, ischemia

Question 20

primary BNP cause by

Answer 20

ventricular stretch (measure of preload)

Question 21

Secondary BNP caused by

Answer 21

hyperadrenergic state, RAAS activation, ischemia