Heart Failures

Question 1

What is HF

Answer 1

Clinical syndrome with symptoms and signs caused by structural/functional cardiac abnormality and corroborated by high natriuretic peptide levels and/or evidence of pulmonary or systemic congestion

Question 2

Typical symptoms of heart failure

Answer 2

Breathlessness
Orthopnea
PND
reduced exercise tolerance
Fatigue, tiredness
Increased recovery time after exercise
Ankle swelling

Question 3

Less typical symptoms of HF

Answer 3

Nocturnal cough
Wheezing
Bloated feeling
Loss of appetite
Confusion
Depression
Palpitation
Dizziness
Syncope
Bendopnea

Question 4

Specific signs of HF

Answer 4

Elevated JVP

Hepatojugular reflux
Third heart sound
Laterally displaced apex beat

Question 5

Less specific signs of HF

Answer 5

Weight gain
Weight loss when advanced
Cachexia
Cardiac murmur
Peripheral edema ( sacral , pedal )
Crépitations
Pleural effusion
Tachycardia
Irregular pulse
Cheyne stokes respi
Hepatomegaly
Ascites
Cold extremities
OLiguria
Narrow pulse pressure

Question 6

Type of HF

Answer 6

LVF
RVF
CHF

Question 7

LHF main symptoms and signs

Answer 7

Dyspnoea
Fatigue
Orthopnea
PND
pulmonary edema

Question 8

RHF symptoms and signs

Answer 8

Edema
Elevated JVP
tender hepatomegaly
Hepatojugular reflux

Question 9

What is class I HF

Answer 9

No limitation of physical activity
No symptoms on ordinary physical activity

Question 10

What is class II HF

Answer 10

Slight limitation of physical activity
Comfortable at rest
Breathlessness, fatigue, palpitations on ordinary physical activity g

Question 11

What is class III HF

Answer 11

Marked limitation of activity
Comfortable at rest
Symptoms present when less than ordinary physical activity

Question 12

What is class IV HF

Answer 12

discomfort in any form of activity
Symptoms at rest
Increased discomfort on activity

Question 13

Characteristics of left heart failure

Answer 13

Reduced left ventricular output
Increased left atrial and pulmonary venous pressure

Question 14

Characteristics of right heart failure

Answer 14

Reduced right ventricular output

Increased right atrial/pulmonary venous pressure

Question 15

What is systolic heart failure

Answer 15

Pumping problem
Reduced ejection fraction and enlarged ventricles.
Presents with left ventricular failure and marked cardiomegaly.

Question 16

What is diastolic heart failure

Answer 16

Filling problem
Increased resistance to filling due to increased filling pressure.
Presents with pulmonary congestion with normal or slightly enlarged ventricles.

Question 17

What is heart failure with reduced ejection fraction

Answer 17

Heart failure with reduced ejection fraction
EF <40%
Concomitant systolic and diastolic dysfunction

Question 18

What is heart failure with preserved ejection fraction

Answer 18

Heart failure with preserved ejection fraction
EF>40%
Seen in diastolic dysfunction.

Question 19

What is high output heart failure

Answer 19

Cardiac output is higher than normal due to increased peripheral demand
less common

Question 20

Causes of high output cardiac failure

Answer 20

Anemia, hyperthyroidism , pregnancy, obesity, arteriovenous shunt , lung diseases…

Question 21

What is low output heart failure

Answer 21

Reduced cardiac output due to reduced pumping activity of the heart
Reduced EF with end organ hypoperfusion
less common

Question 22

Risk factors of heart failure

Answer 22

Predominant in the elderly population. ( >70 years old )
Obesity
Alcoholism
Smoking
High cholesterol

Hypertension
Diabetes
Valvular heart disease
Coronary heart disease
Cardiomyopathies
Viral infections
Congenital heart defects