Systolic and Diastolic HF

Question 1

4 Classifications of HF

Answer 1

I - Symptomatic w/ greater than ordinary activity
II - ordinary activity
III - minimal activity
IV - symptomatic at rest

Question 2

Stage C

Answer 2

Structural Disease. Once EF < 40%, pt needs to be on BB unless contraindication. Because once has scar, can experience sudden death

Question 3

Stage D

Answer 3

Refractory disease requiring special intervention, start ionotropes

Question 4

Alpha1 Stimulation (2)

Answer 4

Increase both AL and PL, but also induce kidney to produce renin which isn’t what you really want in HF

Question 5

Biggest Problem of RAS in HF

Answer 5

AT I R can lead to myocardial fibrosis, which sucks donkey nuts

Question 6

2 Hemodynamic Profile of HF Aspects

Answer 6

Congestion (dry-wet little-a lot)

Perfusion (cold-warm little-a lot)

Question 7

Highest Specificity Sign of HF (& 2nd)

Answer 7

Increased JVP (S3 also high)

Question 8

Bad Drug Combo w/ ACEis

Answer 8

NSAIDs

Question 9

E and A on Echocardiogram

Answer 9

E is passive ventricular filling, A is atrial kick

Question 10

Low EF Treatment Protocol (5)

Answer 10

ACEi (ARB if intolerant) and BBs, maybe aldosterone antagonist
Digitalis
Ionotropes Harmful, but may increase QoL palliatively

Question 11

Seattle Heart Failure Model

Answer 11

Predict lifespan

Question 12

3 Strongest Predictors of ADHF

Answer 12

High BUN, low SBP, High Serum Creatinine

Question 13

Implantable Defibrillators (ICD)

Answer 13

Shock you or w/e but it’s fucking miserable and you die from pulmonary edema which fucking sucks

Question 14

Left Ventricular Assist Device

Answer 14

Basically sucks in blood and pumps it into aorta, pretty solid. Can be pulsatile or continuous flow