Lecture 17

Question 1

Heart failure

Answer 1

Inability of the heart to meet body demands

Reduced CO
Tissue hypoperfusion
Increased pulmonary pressures

Question 2

Causes of heart failure

Answer 2

Fibrosis - less elastic so contracts less
Hypertrophy
Ischaemic heart disease

Less common:
high output HF - elevated demand
Sepsis 
Severe anaemia 
Thyrotoxicosis

Question 3

Ejection fraction

Answer 3

SV / EDV

Typically 60%
Normal 50+%

Depends on myocardial contractility
Increased after load

Question 4

HFrEF - heart failure with reduced EF

Answer 4

Most common
Systolic dysfunction
SV decreased
Contractility problem

Question 5

HFpEF - heart failure with preserved EF

Answer 5

SV and EDV decreased
Diastolic dysfunction (filling)

Question 6

Symptoms of left ventricular heart failure

Answer 6

Orthopnoea - breathless when lying flat
Paroxysmal nocturnal dyspnoea - breathless at night must sit up
Basal pulmonary cackles (crepitations)
Cardiomegaly - displaced apex beat LV hypertrophy

Question 7

Right ventricular HF symptoms

Answer 7

Pulmonary oedema
Raised JVP
Liver congestion - tender and smooth

Question 8

Furosemide

Answer 8

immediate venodilation

Diuretic after 30 mins

Question 9

Heart failure

Answer 9

ACE inhibitor or angiotensin receptor blocker

Aldosterone receptor antagonist - spironolactone