W24 Heart Failure

Question 1

What is heart failure

Answer 1

inability of the cardiac muscle to keep up with demand therefore inadequate blood supplied to organs

Question 2

what are the 2 types of heart failure

Answer 2

systolic (squeeze)

Diastolic (filling)

Question 3

what are the 3 forms of heart failure

Answer 3

left
right
bilateral

Question 4

how is severity of heart failure measured

Answer 4

echocardiogram

Question 5

what is normal ejection fraction

Answer 5

50 - 70%

Question 6

what is pump failure classified as

Answer 6

41 - 49% mild pump failure

30- 40% moderate pump failure

<35% severe pump failure

Question 7

what is filling failure

Answer 7

heart failure with preserved ejection

Question 8

what is it called when ejection fraction is too high

Answer 8

> 75% indicated hypertrophic cardiomyopathy

Question 9

what are the 4 classes of heart failure

Answer 9

class 1 - no symptoms and no limitation in ordinary activity

class 2 - mild symptoms and slight limitation during ordinary activity

class 3 - marked limitation in activity due to symptoms comfortable only at rest

class 4 - severe limitations. Symptoms even at rest. Mostly bed bound

Question 10

what is the aim of treatment in heart failure

Answer 10

reduce mortality

delay dsiease progression

control symptoms and subsequently improve quality of life

Question 11

What are 4 red flag symptoms of heart failure

Answer 11

dypsnoea (breathlessness)

orthopneoa (breathlessness on lying flat)

Paroxyzmal nocturnal dyspnoea (breathlessness attacks during night)

peripheral oedema

Question 12

what are other alerting symptoms of heart failure

Answer 12

Tachycardia

Reduced frequency of urination due to kidneys retaing excess fluid

Confusion / altered mental state, loss of appetite tiredness

Loss of appetite

Tiredness

Question 13

what drugs can be used to manage heart failure

Answer 13

diuretics

ace inhibitors

beta blockers

Question 14

how can diuretics help heart failure

Answer 14

remove excess fluid from lungs and periphery

symptom management

Question 15

how can ace inhibitors help heart failure

Answer 15

lower blood pressure and vascular resistance

reduce mortality by 35%

Question 16

how can beta blockers manage heart failrure

Answer 16

lower cardiac load by reducing heart rate and force of contraction

Question 17

what second line treatment is there for heart failure

Answer 17

Aldosterone receptor blocker
- spironolactone or eplerenone
- reduces circulating aldosterone
Sacubitril / Valsartan
- Stop ACEi or ARB
- Neprilysin inhibitor
Ivabradine
- If HR > 75 BPM despite optimal B blocker therapy
Hydralaizine + nitrate

Question 18

what is the third line treatment

Answer 18

digoxin

Question 19

what do we monitor in regard to diuretics

Answer 19

renal function
electrolytes
blood pressure

Question 20

what do we monitor in regard to ace inhibitors

Answer 20

renal function
potassium
bp

Question 21

what do we need to monitor in regards to beta blockers

Answer 21

heart rate