Management Of Chronic HF

Question 1

What are the three aims of treatment?

Answer 1

Treat the cause (arrythmias), the exacerbating factors (anaemia thyroid disease, high BP) and avoid exacerbating factors (NSAIDs 10 fold risk and vermapril)

Question 2

What drugs are used?

Answer 2

Diuretics, ACEIs, beta blockers, spironolactone (k sparing but no effect when balanced out by ACEIs), digoxin, vasodilator (hydralazine, isorbidide dinatrate)

Question 3

What do you do if patient has intractable HF

Answer 3

Reassess cause, stronger drugs, bed rest, Na restriction, loop diuretics, daily wight and U+Es (test for hypokalemia), DVT prophylaxis with heparin and TED stockings

Question 4

What is NY class 1 HF?

Answer 4

Heart disease but no dyspnoea from daily activities

Question 5

What is NY stage 2?

Answer 5

Comfortable at rest, dyspnoea during ordinary activity

Question 6

What is NY stage 3?

Answer 6

Limiting dyspnoea (occurs at level below normal activities)

Question 7

What is NY stage 4?

Answer 7

Dyspnoea at rest, all activity causes discomfort

Question 8

What lifestyle factors must be modified?

Answer 8

Smoking, salt intake, weight, nutrition