Systolic heart failure

Question 1

Anatomical structures

Answer 1

usually LV- but can be RV

Question 2

Structural abnormalities

Answer 2

Ventricles often dilated due to heart’s attempt to pump more blood
Valve regurgitation
Mitral or tricuspid valve regurgitation may result from ventricular dilation due to stretching of the valve ring

Question 3

Physiological abnormalities

Answer 3

Heart loses ability to pump enough blood

The heart loses its pumping reserve

Question 4

Prior events

Answer 4

Most common: MI
Viral myocarditis
Chemotherapy

Question 5

Experienced symptoms

Answer 5

Tiredness, breathlessness (dyspnoea),
breathlessness when lying flat (orthopnoea),
sudden breathlessness in the night (paroxysmal nocturnal dyspnoea),
passing excess urine at night (Nocturia),
ankle swelling

Question 6

signs

Answer 6

Tachypnoea (rapid respiration),
 oedema,
 high jugular venous pressure
Tachycardia
Hypotension 
Cachexia (loss of skeletal muscle mass)
Anorexia

Question 7

Abnormal test results

Answer 7

Echocardiogram- dilated heart chambers which contract weakly- valves may be leaky
Blood test of hormone BNP (Brain Natiuretic Peptide) raised
ECG abnormal due to underlying problem

Question 8

Medical/ surgical intervention

Answer 8

Weigh themselves daily- detect changes in fluid retention
Loop diurectic e.g. furosemide
Potassium retaining diuretic e.g. spironolactone
ACE-inhibitor e.g. ramipril
Beta blocker
Some patients- special pacemaker that ‘resynchronises’ the R and L ventricle systolic contraction