Investigation And Management Of Heart Failure

Question 1

What is the most common cause of HF?

Answer 1

IHD- ischaemic heart disease

Question 2

What is chronic heart failure?

Answer 2

Syndrome characterised by a set of clinical signs:

1. Pulmonary congestion
2. Venous congestion
3. Dependent oedema

And symptoms:

1. Dyspnoea
2. Lethargy
3. Orthopnoea (shortness of breath that occurs when lying down)

Question 3

How much fluid needs to collect in the lungs before it becomes clear or visible on a chest x-ray?

Answer 3

Half a litre

Question 4

Where is the internal jugular vein?

Answer 4

Starts in between the sternal head and the clavicular head of the SCM. From there is runs in a straight line up to the angle of the jaw

Question 5

What drugs are recommended for the treatment of HF?

Answer 5

ACE inhibitors
[Sacubiril/valsartan (in the place of ACE inhibitors)]
+
Beta blockers

If person remains symptomatic after initial treatment then MRA is given (mineralocorticoid receptor antagonist)

Question 6

What could be the presentation of HF on an ECG?

Answer 6

Wide QRS complex
Caused by left bundle branch block

*often associated with mitral regurgitation

**wider the QRS complex the worse the LBBB and therefore the worse the prognosis

Question 7

How is LBBB treated?

Answer 7

Biventricular pacemaker leads