Treatment of Heart Failure

Question 1

What causes heart failure?

Answer 1

Structural/functional abnormalities of the heart causing the metabolic needs of the body not being met

Question 2

What are the 3 categories of HF?

Answer 2

1. LVEF <50%
2. LVEF 40-49%
3. LVEF <30%

Question 3

What are the symptoms of HF?

Answer 3

SOB
Oedema
Fatigue
Tachycardia
Fluctuating weight
Wheezing

Question 4

What are the 2 main 1st line treatment options for HF?

Answer 4

ACEi
B-blockers

Both to be titrated up

Question 5

What other treatment options are available for HF?

Answer 5

Hydralazine
ARB if ACEi not tolerated - sartans
Spironolactone
Ivabradine
SGLT-2i - flozins
Loop diuretics for oedema - furosemide, bumetanide

Question 6

Why is digoxin not commonly given for HF?

Answer 6

Because it can interact with b-blockers & cause hypokalaemia

Question 7

What are the monitoring parameters for HF?

Answer 7

Renal function
U&E
Weight
BP
HR

Question 8

What 2 conditions can loop diuretics cause?

Answer 8

Hypokalaemia
Hyponatraemia

Question 9

What specific monitoring is needed for ACEi?

Answer 9

K+
Na+
Renal function - eGFR and CrCl

Question 10

What symptoms should you monitor if a patient is on an ARB?

Answer 10

Nausea + vomiting