Heart Failure Treatments and Challenges

Question 1

Types of heart Failure

Answer 1

HFpEF and HFrEF

Question 2

what is heart failure

Answer 2

heart’s inability to meet body’s metabolic needs

Question 3

Heart failure is defined by

Answer 3

insufficient cardiac output

Question 4

what limits cardiac output in heart failure (2)

Answer 4

LV filling or geometry

Question 5

LV

Answer 5

Left ventricle

Question 6

what is HF associated with at rest or with stress

Answer 6

elevated intracardiac pressure

Question 7

HF common feature

Answer 7

cardiac hypertrophy

Question 8

HFrEF features (3)

Answer 8

reduced ejection fraction, impaired contractility, systolic dysfunction

Question 9

HFpEF features (3)

Answer 9

preserved ejection fraction, impaired relaxation, diastolic dysfunction

Question 10

reduced ejection fraction

Answer 10

<50% LV EDV

Question 11

preserved ejection fraction

Answer 11

> /= 50% LV EDV

Question 12

LV EDV

Answer 12

Left ventricular end diastolic volume

Question 13

HF signs (7)

Answer 13

dyspnea, orthopnea, reduced exercise tolerance, fatigue, peripheral oedema, elevated JVP, third heart sound, age

Question 14

JVP

Answer 14

jugular venous pressure

Question 15

dyspnea

Answer 15

breathlessness

Question 16

what can cause dyspnea

Answer 16

pulmonary oedema

Question 17

orthopnea

Answer 17

difficulty breathing lying down

Question 18

how does peripheral oedema commonly present

Answer 18

ankle swelling

Question 19

HFpEF male age risk

Answer 19

> 70

Question 20

HFpEF female age risk

Answer 20

> 75

Question 21

HF comorbidities (12)

Answer 21

ischaemia, AF, valvular heart disease, lung disease, hypertension, stroke, kidney dysfunction, kidney failure, obesity, diabetes, hypokalaemia, hyperkalaemia, hyperlipidaemia

Question 22

ischaemia

Answer 22

CAD

Question 23

CAD

Answer 23

coronary artery disease

Question 24

common lung diseases with HF (2)

Answer 24

COPD and asthma

Question 25

COPD

Answer 25

chronic obstructive pulmonary disease

Question 26

Clinical signs for HF dignosis (3)

Answer 26

elevated JVP, laterally displaced apical beat, third heart sound

Question 27

increased ventricular pressure will lead to increased (3)

Answer 27

pulmonary pressure, pressure in right heart, pressure in central veins

Question 28

what causes a lateral shift of heart apex

Answer 28

hypertrophy

Question 29

S1

Answer 29

mitral and tricuspid valve closure

Question 30

S2

Answer 30

aortic and pulmonary valve closure

Question 31

when does S3 occur

Answer 31

early diastole

Question 32

S3

Answer 32

turbulent blood flow into LV

Question 33

what does S3 indicate

Answer 33

high intracardiac pressure

Question 34

what makes HF diagnosis hard

Answer 34

signs can be variable and indicative

Question 35

indicative

Answer 35

normal

Question 36

How is MI excluded

Answer 36

no elevation in cardiac enzymes

Question 37

what cardiac enzymes are assessed

Answer 37

Troponin I

Question 38

what is normally increased more in HFrEF than HFpEF

Answer 38

NT-proBNP

Question 39

NT-proBNP

Answer 39

plasma natriuretic peptide

Question 40

when is NT-proBNP also elevated (3)

Answer 40

renal failure, age, AF

Question 41

what can be used to exclude ischaemic events and AF

Answer 41

ECG

Question 42

is an ECG conclusive for HF

Answer 42

no

Question 43

what is an M mode echo

Answer 43

ultrasound echo motion mode

Question 44

Tests for HF (3)

Answer 44

non invasive stress exercise test, invasive intra cardiac pressure exercise and imaging, M mode echo

Question 45

ideal HF test

Answer 45

M mode echo

Question 46

non invasive stress exercise test limitations (2)

Answer 46

false positives and requires treadmill use

Question 47

invasive intra-cardiac pressure exercise and imaging limitations (2)

Answer 47

invasive and not ideal for older patients

Question 48

m mode echo measures (3)

Answer 48

hypertrophy, left atrial dimension, central pressure