CV 4
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Questions and Answers

Which classification system is commonly used for heart failure?

  • Prevalence similar among men and women
  • Classification based on activity
  • Classes I - IV (correct)
  • Acuity defined by change of signs and symptoms requiring emergency management

    • What is the normal range for cardiac index?

  • 6 - 8 L/min/m2
  • 4 - 6 L/min/m2
  • 1 - 2 L/min/m2
  • 2.2 - 4 L/min/m2 (correct)

    • What is the most common cause of chronic heart failure?

  • Valvular or pericardial disease
  • Hypertension
  • Cardiomyopathy
  • Coronary artery disease (correct)

    • What is the primary mechanism involved in heart failure with low cardiac output?

    <p>Volume overload</p> Signup and view all the answers

    Which adaptive response helps maintain heart function in heart failure?

    <p>Activation of the sympathetic nervous system</p> Signup and view all the answers

    What is the most common cause of myocardial remodeling in heart failure?

    <p>Ischemic injury</p> Signup and view all the answers

    Which symptom is an early subjective finding of heart failure?

    <p>Dyspnea</p> Signup and view all the answers

    Which physical finding is commonly associated with heart failure?

    <p>Heart gallop</p> Signup and view all the answers

    Which diagnostic test is essential for the diagnosis of heart failure?

    <p>Echocardiogram</p> Signup and view all the answers

    What is the primary goal of heart failure management?

    <p>Manage the symptoms</p> Signup and view all the answers

    Which therapy is most commonly used for the management of heart failure?

    <p>Cardiac Resynchronization therapy (CRT)</p> Signup and view all the answers

    Which factor is associated with a poor prognosis in heart failure?

    <p>EF lower than 25%</p> Signup and view all the answers

    Which medication should be continued during anesthesia in heart failure patients?

    <p>Beta blockers</p> Signup and view all the answers

    Which type of anesthesia can be used in heart failure patients?

    <p>Volatile anesthesia</p> Signup and view all the answers

    What is the most important focus in the emergency phase of acute heart failure therapy?

    <p>Nitric Oxide Synthase Inhibitors</p> Signup and view all the answers

    What is the mortality rate during the first 4 years after the diagnosis of heart failure?

    <p>Around 40%</p> Signup and view all the answers

    Which therapy is not commonly used for the management of heart failure?

    <p>Renal metabolism</p> Signup and view all the answers

    Which medication should be discontinued 24 hours before surgery in heart failure patients?

    <p>Digoxin</p> Signup and view all the answers

    Which factor is not associated with a poor prognosis in heart failure?

    <p>EF higher than 25%</p> Signup and view all the answers

    Which phase of heart failure therapy focuses on emergency management?

    <p>Emergency phase</p> Signup and view all the answers

    Which equation represents the calculation for cardiac output (CO)?

    <p>CO = HR x SV</p> Signup and view all the answers

    What are the three main factors that control heart rate (HR)?

    <p>Autonomic nervous system, hormonal control, and preload</p> Signup and view all the answers

    What is the definition of congestive heart failure?

    <p>It is the pathophysiological process in which the heart is unable to meet the metabolic requirements of the tissue.</p> Signup and view all the answers

    What are the possible causes of congestive heart failure?

    <p>Impaired myocardial contractility, cardiac valve abnormalities, and systemic hypertension</p> Signup and view all the answers

    What are the different forms or characteristics of heart failure?

    <p>Systolic vs Diastolic, Acute vs Chronic, and Left vs Right</p> Signup and view all the answers

    What is the equation for calculating vascular systemic resistance (SvR)?

    <p>SvR = mean arterial pressure (MAP) / cardiac output (CO)</p> Signup and view all the answers

    What is the management approach for a patient with congestive heart failure?

    <p>Observation</p> Signup and view all the answers

    What does the abbreviation "H SUR" stand for in the text?

    <p>Hypertensive heart disease</p> Signup and view all the answers

    What is the term used to describe the persistent opening between the aorta and the pulmonary artery?

    <p>Patent ductus arteriosus</p> Signup and view all the answers

    What is the purpose of cardioversion?

    <p>To restore normal heart rhythm</p> Signup and view all the answers

    Which equation represents the calculation for cardiac output (CO)?

    <p>CO = HR imes SV</p> Signup and view all the answers

    What are the three main factors that control heart rate (HR)?

    <p>Autonomic nervous system, hormonal control, and preload</p> Signup and view all the answers

    What is the most common cause of chronic heart failure?

    <p>Systemic hypertension</p> Signup and view all the answers

    Which diagnostic test is essential for the diagnosis of heart failure?

    <p>Echocardiogram</p> Signup and view all the answers

    What is the purpose of cardioversion?

    <p>To restore normal heart rhythm</p> Signup and view all the answers

    What does the abbreviation 'H SUR' stand for in the text?

    <p>High systemic vascular resistance</p> Signup and view all the answers

    Which classification system is commonly used for heart failure?

    <p>ACC and AHA 2005</p> Signup and view all the answers

    What is the most common cause of chronic heart failure?

    <p>Coronary artery disease</p> Signup and view all the answers

    What is the normal range for cardiac index?

    <p>2.2 – 4 L/min/m2</p> Signup and view all the answers

    Which medication should be discontinued 24 hours before surgery in heart failure patients?

    <p>Beta blockers</p> Signup and view all the answers

    What is the primary goal of heart failure management?

    <p>To reverse pathophysiologic alterations</p> Signup and view all the answers

    Which diagnostic test is essential for the diagnosis of heart failure?

    <p>ECG</p> Signup and view all the answers

    Which of the following is a surgical therapy option for the management of heart failure?

    <p>Cardiac Resynchronization therapy (CRT)</p> Signup and view all the answers

    Which of the following is a mechanical device used in the management of acute heart failure?

    <p>Biventricular pacing</p> Signup and view all the answers

    What is the most common cause of death in heart failure patients in the United States?

    <p>Kidney failure</p> Signup and view all the answers

    Which factor is associated with a poor prognosis in heart failure?

    <p>Presence of multifocal premature ventricular contractions</p> Signup and view all the answers

    Which medication should be continued during anesthesia in heart failure patients?

    <p>Beta blockers</p> Signup and view all the answers

    Which phase of heart failure is often encountered in the perioperative and/or operating room?

    <p>Emergency phase</p> Signup and view all the answers

    What is the mortality rate during the first 4 years after the diagnosis of heart failure?

    <p>40%</p> Signup and view all the answers

    Which medication should be discontinued 24 hours before surgery in heart failure patients?

    <p>ACE inhibitors</p> Signup and view all the answers

    Which of the following is a characteristic of hypertrophic cardiomyopathy (HCM)?

    <p>Normal ventricular wall thickness</p> Signup and view all the answers

    What is the primary means of relieving the signs and symptoms of HCM?

    <p>Pharmacologic therapy</p> Signup and view all the answers

    Which drug or event improves left ventricular outflow tract (LVOT) obstruction in HCM?

    <p>Decreased myocardial contractility</p> Signup and view all the answers

    Which diagnostic test is essential for the diagnosis of HCM?

    <p>Echocardiogram</p> Signup and view all the answers

    Which medication should be continued during anesthesia in patients with HCM?

    <p>Beta blockers</p> Signup and view all the answers

    Which of the following is a common symptom of restrictive cardiomyopathy?

    <p>Atrial fibrillation</p> Signup and view all the answers

    What is the main pathophysiologic determinant of cor pulmonale?

    <p>Pulmonary hypertension</p> Signup and view all the answers

    Which diagnostic test is commonly used to assess right atrial and right ventricular hypertrophy in cor pulmonale?

    <p>ECG</p> Signup and view all the answers

    What is the most common cause of cor pulmonale?

    <p>COPD</p> Signup and view all the answers

    What is the prognosis of secondary cardiomyopathy with restrictive physiology?

    <p>Very poor</p> Signup and view all the answers

    Which of the following is a characteristic of cardiomyopathies?

    <p>They are diseases of the myocardium associated with mechanical and/or electrical dysfunction.</p> Signup and view all the answers

    What is the most common form of hypertrophic cardiomyopathy (HCM)?

    <p>Hypertrophy of the septum and anterolateral free wall.</p> Signup and view all the answers

    What is the prevalence of hypertrophic cardiomyopathy (HCM)?

    <p>1 in 500.</p> Signup and view all the answers

    How is hypertrophic cardiomyopathy (HCM) transmitted?

    <p>As an autosomal dominant trait with variable penetrance.</p> Signup and view all the answers

    What is the primary characteristic of hypertrophic cardiomyopathy (HCM)?

    <p>Left ventricular (LV) hypertrophy in the absence of any other cardiac disease.</p> Signup and view all the answers

    Which type of cardiomyopathy is the most common cause of heart failure?

    <p>Dilated cardiomyopathy</p> Signup and view all the answers

    What is the estimated incidence of peripartum cardiomyopathy?

    <p>1 in 3000 live births</p> Signup and view all the answers

    Which factor is NOT associated with a poor prognosis in dilated cardiomyopathy?

    <p>Systemic hypotension</p> Signup and view all the answers

    Which treatment option is teratogenic but can be useful following delivery in peripartum cardiomyopathy?

    <p>ACE inhibitors</p> Signup and view all the answers

    What is the primary mechanism involved in heart failure with low cardiac output?

    <p>Decreased contractility</p> Signup and view all the answers

    Which of the following is a common treatment goal for right-sided heart failure in patients with COPD?

    <p>Maintaining arterial oxygenation above 60 mm Hg</p> Signup and view all the answers

    What is the prognosis for patients with COPD and mild pulmonary hypertension?

    <p>Favorable</p> Signup and view all the answers

    Which of the following is NOT recommended for anesthesia management in patients with cor pulmonale?

    <p>Monitoring respiratory and cardiovascular status in the postoperative period</p> Signup and view all the answers

    What is the principal pathophysiologic derangement in the development and progression of heart failure?

    <p>Ventricular remodeling</p> Signup and view all the answers

    What is the most common cause of hypertrophic cardiomyopathy (HCM)?

    <p>Genetic factors</p> Signup and view all the answers

    Which factor can induce left ventricular outflow tract (LVOT) obstruction in hypertrophic cardiomyopathy (HCM)?

    <p>Hypovolemia</p> Signup and view all the answers

    What is the most common form of cardiomyopathy?

    <p>Dilated cardiomyopathy</p> Signup and view all the answers

    What is the recommended treatment for outflow tract obstruction in hypertrophic cardiomyopathy?

    <p>Phenylephrine</p> Signup and view all the answers

    What is cor pulmonale?

    <p>Right ventricular enlargement</p> Signup and view all the answers

    What is the most important determinant of the development of pulmonary hypertension and cor pulmonale in patients with chronic lung disease?

    <p>Alveolar hypoxia</p> Signup and view all the answers

    Which of the following is a key feature of hypertrophic cardiomyopathy (HCM)?

    <p>Increased left ventricular outflow tract (LVOT) obstruction</p> Signup and view all the answers

    Which event may worsen left ventricular outflow tract (LVOT) obstruction in hypertrophic cardiomyopathy (HCM)?

    <p>Increased myocardial contractility</p> Signup and view all the answers

    Which medication should be continued during anesthesia in patients with hypertrophic cardiomyopathy (HCM)?

    <p>Beta blockers</p> Signup and view all the answers

    Which of the following is true about cardiomyopathies?

    <p>They can be confined to the heart or part of generalized systemic disorders</p> Signup and view all the answers

    What is the most common form of hypertrophic cardiomyopathy (HCM)?

    <p>Hypertrophy of the septum and anterolateral free wall</p> Signup and view all the answers

    What is the prevalence of hypertrophic cardiomyopathy (HCM)?

    <p>1 in 500</p> Signup and view all the answers

    Which type of cardiomyopathy is the most common cause of heart failure?

    <p>Dilated cardiomyopathy</p> Signup and view all the answers

    Which diagnostic test is essential for the diagnosis of peripartum cardiomyopathy?

    <p>Echocardiogram</p> Signup and view all the answers

    What is the estimated incidence of peripartum cardiomyopathy?

    <p>1 in 3000 to 1 in 4000 live births</p> Signup and view all the answers

    Which of the following is a common symptom of restrictive cardiomyopathy?

    <p>Pulmonary congestion</p> Signup and view all the answers

    What is the most common cause of cor pulmonale?

    <p>COPD</p> Signup and view all the answers

    Which diagnostic test can be used to identify right atrial and right ventricular hypertrophy in cor pulmonale?

    <p>ECG</p> Signup and view all the answers

    Which of the following is a characteristic of cor pulmonale?

    <p>It is characterized by dyspnea and fatigue as specific symptoms.</p> Signup and view all the answers

    What is the primary treatment goal in patients with cor pulmonale?

    <p>Decreasing pulmonary vascular resistance and pulmonary artery pressure.</p> Signup and view all the answers

    Which medication should be avoided during anesthesia in patients with cor pulmonale?

    <p>Muscle relaxants associated with histamine release</p> Signup and view all the answers

    Which medication is commonly used to increase afterload in the management of outflow tract obstruction in hypertrophic cardiomyopathy (HCM)?

    <p>Phenylephrine</p> Signup and view all the answers

    What is the most common form of cardiomyopathy and the second most common cause of heart failure?

    <p>Dilated cardiomyopathy</p> Signup and view all the answers

    What is the main pathophysiologic determinant of the development of pulmonary hypertension and cor pulmonale in patients with chronic lung disease?

    <p>Alveolar hypoxia</p> Signup and view all the answers

    What is the best available treatment to improve the prognosis in patients with chronic lung disease and cor pulmonale?

    <p>Long-term oxygen therapy</p> Signup and view all the answers

    What is right ventricular enlargement (hypertrophy and/or dilation) that may progress to right-sided heart failure called?

    <p>Cor pulmonale</p> Signup and view all the answers

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