Session 10.2

Question 1

What’s the classification for progressive heart failure?

Answer 1

Class 1
- no symptomatic limitation of physical activity

Class 2
- slight limitation, activity results in symptoms

Class 3
- marked limitation i physical activity, do a little to feel symptoms

Class 4

• inability to carry out physical activity without symptoms
• may have symptoms at rest

Question 2

What investigations can be done to confirm heart failure?

Answer 2

Blood test

• FBC
• electrolytes and renal function
• BNP (brain natriuretic peptide) (released by cardiomyocytes in response to stretching caused by increased ventricular volume)
• x ray
• echocardiogram
• MRI
  Etc.

Question 3

How would you manage acute heart failure?

Answer 3

• admit to hospital
• oxygen
• intravenous loop diuretic (furosemide)
• heparin to prevent DVT

Also lifestyle changes

Question 4

What drugs would you give to treat heart failure and why?

Answer 4

1) ACE inhibitors
- prevent RAAS system
- prevents increase in preload and afterload

2) B blockers
- prevents increased sympathetic drive that increases HR
- reduces BP increase

3) Spironolactone
- aldosterone receptor antagonist
- inhibits RAAS pathway

Overall, prevent increase in cardiac work.