Congestive Heart Failure: Types and Symptoms

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Questions and Answers

Which type of heart failure involves the left ventricle's inability to relax or fill fully?

Congenital heart disease

Diastolic heart failure (correct)

Right-sided heart failure

Systolic heart failure

What is the most common cause of congestive heart failure in infancy?

Viral myocarditis

Volume overload lesions (correct)

Rheumatic valvular heart disease

Tachyarrhythmias

Which condition is NOT a cause of congestive heart failure?

Hypoglycemia

Hyperglycemia (correct)

Acidosis

Severe hypoxia

What is the main clinical manifestation of congestive heart failure in older children?

Shortness of breath Signup and view all the answers

Which classification system for heart failure categorizes the stage where symptoms occur even at rest?

(NYHA) class 4 Signup and view all the answers

What is the common effect of right-sided heart failure?

Swelling in the abdomen, legs, and feet Signup and view all the answers

Which type of heart disease is a common cause of congestive heart failure in infants?

Congenital heart diseases Signup and view all the answers

What is the main clinical manifestation of congestive heart failure in infants?

Tachypnoea Signup and view all the answers

Which condition can cause congestive heart failure in newborns?

Hypocalcemia Signup and view all the answers

What is the characteristic of systolic heart failure?

The left ventricle can't contract vigorously Signup and view all the answers

Which of the following are signs of systemic venous congestion in children with heart failure?

Puffy eyelids and distended neck veins, hepatomeg & ankle edema Signup and view all the answers

What is the recommended initial management for heart failure in children?

Elimination of underlying causes or correction of contributing factors Signup and view all the answers

What is the Total Digitalizing Dose (TDD) range when digitalizing a child with heart failure?

20-50 micrograms/kg Signup and view all the answers

What is the recommended baseline test before administering digitalis to a child with heart failure?

Baseline electrocardiogram (ECG) and electrolytes Signup and view all the answers

What do arteriolar vasodilators do in the management of heart failure in infants?

Augment the stroke volume Signup and view all the answers

What are the signs of pulmonary venous congestion in children with heart failure?

Tachypnea and dyspnea on exertion Signup and view all the answers

When is cardiac transplantation considered as an option in children with heart failure?

When there is no improvement with medical therapy within a few weeks to months Signup and view all the answers

What is the role of beta-adrenergic blockers in the treatment of chronic heart failure?

May be beneficial in chronic heart failure Signup and view all the answers

Which test is NOT helpful in determining the presence of heart failure but can help determine the cause?

Electrocardiogram (ECG) Signup and view all the answers

What is indicated when there is non-improvement with medical therapy within a few weeks to months for children with heart failure?

Cardiac transplantation Signup and view all the answers

What is the recommended initial treatment for hyperthyroidism in children with heart failure?

TSH levels Signup and view all the answers

Match the type of heart failure with its characteristic manifestation:

Left-sided heart failure = Fluid may back up in the lungs, causing shortness of breath. Right-sided heart failure = Fluid may back up into the abdomen, legs and feet, causing swelling. Systolic heart failure = The left ventricle can't contract vigorously, indicating a pumping problem. Diastolic heart failure = The left ventricle can't relax or fill fully, indicating a filling problem. Signup and view all the answers

Match the cause of heart failure with its associated condition:

Congenital HD = Volume overload lesions such as VSD, PDA are the most common causes of CHF in the first 6 months of life. Acquired Heart disease = Viral myocarditis, Acute rheumatic carditis, Rheumatic valvular heart disease. Idiopathic dilated cardiomyopathy = Doxorubicin cardiomyopathy, Cardiomyopathies associated with muscular dystrophies. Miscellaneous causes = Metabolic abnormalities, Severe hypoxia, Acidosis, Hypoglycemia, Hypocalcemia (newborns), Hyperthyroidism, SVT, Complete heart block, Severe anaemia, Bronchopulmonary dysplasia Signup and view all the answers

Match the HF classification system with its respective stage:

New York Heart Association (NYHA) classification system = Class I: No limitation of physical activity; Class II: Slight limitation of physical activity; Class III: Marked limitation of physical activity; Class IV: Symptoms occur even at rest; discomfort with any physical activity. American College of Cardiology/American Heart Association (ACC/AHA) staging system = Stage A: High risk of heart failure but no structural heart disease or symptoms of heart failure; Stage B: Structural heart disease but no symptoms of heart failure; Stage C: Structural heart disease and symptoms of heart failure; Stage D: Refractory heart failure requiring specialized interventions. Signup and view all the answers

Match the clinical manifestation with the age group it is commonly observed in:

In Infants = Poor feeding of recent onset; Tachypnoea; Poor weight gain; Cold sweat on the forehead. In older children = Shortness of breath; Easy fatiguability; Puffy eyelids; Swollen feet. Signup and view all the answers

Match the physiological effect with its corresponding condition in causing congestive heart failure:

Metabolic abnormalities = Severe hypoxia; Acidosis; Hypoglycemia; Hypocalcemia (newborns) Hyperthyroidism = SVT; Complete heart block; Severe anaemia; Bronchopulmonary dysplasia Signup and view all the answers

Match the following drugs used in the management of congestive heart failure with their mechanism of action:

Diuretics = Controls pulmonary and systemic venous congestion Inotropic agents = Increases the contractile state of the myocardium Afterload-reducing agents = Augment the stroke volume Vasodilators = Arteriolar vasodilators Signup and view all the answers

Match the following signs and symptoms of heart failure with their corresponding clinical manifestation:

Tachycardia, gallop rhythm, weak and thready pulse = Compensatory responses to impaired cardiac function Tachypnoea, dyspnoea on exertion = Signs of pulmonary venous congestion Hepatomegaly, puffy eyelids, distended neck veins = Signs of systemic venous congestion Cardiomegaly on CXR = Almost always present in heart failure Signup and view all the answers

Match the following investigations for congestive heart failure with their corresponding diagnostic purpose:

Chest radiograph = Confirmation of cardiomegaly Complete blood count (CBC) = Assessment of blood cell levels Urinalysis = Detection of urinary abnormalities 2-dimensional (2-D) echocardiography = Confirmation of chamber enlargement and impaired LV function Signup and view all the answers

Match the following treatments for heart failure with their specific management purpose:

Elimination of underlying causes or correction of precipitating factors = Treatment consists of Control of heart failure – inotropes, diuretics, afterload reducing agents = General supportive measures Surgery when feasible (valvular disease) = Treatment of underlying causes or contributing factors Antihypertensive treatment for HBP = Management Signup and view all the answers

Match the following drugs used in congestive heart failure with their specific recommended baseline test before administration:

Digitalis = Baseline ECG and electrolytes Beta-adrenergic blockers = Beneficial in chronic CHF Carnitine = In dilated cardiomyopathy Non-improvement with medical therapy within a few weeks to months is an indication = Cardiac transplantation Signup and view all the answers

Match the following conditions with their respective surgical management approach:

Non improvement with medical therapy within a few weeks to months is an indication = Surgery may be palliative or corrective Cardiac transplantation is an option in progressively deteriorating cardiomyopathy = An indication for surgery when feasible Common cause of congestive heart failure in infants = Surgery when feasible (valvular disease) Congestive heart failure in newborns = Packed cell transfusion for anaemia Signup and view all the answers

Study Notes

Heart Failure Types and Characteristics

Left ventricular heart failure involves the inability to relax or fill completely.
Systolic heart failure is characterized by reduced ejection fraction and impaired contraction.

Causes of Congestive Heart Failure

Most common cause of congestive heart failure in infancy: congenital heart disease.
Conditions not associated with congestive heart failure may include isolated arrhythmias or non-cardiac issues.
Right-sided heart failure often causes systemic venous congestion, leading to swelling and fluid retention.

Clinical Manifestations

Main clinical manifestation of congestive heart failure in older children: fatigue and exercise intolerance.
In infants, congestive heart failure manifests primarily through poor feeding, irritability, and rapid breathing.
Signs of pulmonary venous congestion in children include tachypnea, respiratory distress, and wheezing.

Heart Failure Classification

A classification system categorizes advanced heart failure stages where symptoms occur at rest, indicating severe impairment.

Management and Treatment

Initial management for heart failure in children includes medications such as diuretics and ACE inhibitors.
Arteriolar vasodilators are used to decrease systemic vascular resistance and improve cardiac output in infants.
Total Digitalizing Dose (TDD) for digitalizing a child ranges from 10-15 mcg/kg.
Recommended baseline test before administering digitalis: serum electrolytes and renal function tests.

Treatment Options and Considerations

Non-improvement with medical therapy prompts consideration for surgical intervention or advanced therapies, including cardiac transplantation.
Beta-adrenergic blockers play a role in the long-term management of chronic heart failure, improving outcomes and reducing symptoms.
Hyperthyroidism treatment in children with heart failure may include thionamides or beta-blockers as initial therapy.

Diagnostic and Investigative Tools

A chest X-ray is typically not helpful for determining heart failure presence but can indicate underlying causes (e.g., cardiomegaly).
Management strategies may include lifestyle modifications, medications, and, in severe cases, transplantation or mechanical support.

Drugs and Mechanisms

Common drugs used for congestive heart failure include diuretics for fluid management, ACE inhibitors for afterload reduction, and digitalis for augmenting contractility.
Regular monitoring is crucial when using medications, particularly those with narrow therapeutic windows like digitalis.

Surgical and Advanced Interventions

Surgical management may involve procedures like atrial septostomy or closure of congenital defects as needed based on the underlying condition.
Advanced therapies, including left ventricular assist devices, may be considered in children awaiting transplantation.

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Description

This quiz covers an introduction to congestive heart failure, including its clinical condition and types such as left-sided heart failure, right-sided heart failure, and systolic heart failure. Learn about the symptoms and effects of these different types of heart failure.