Podcast
Questions and Answers
What is the epidemiologic magnitude of congestive heart failure (CHF)?
What is the epidemiologic magnitude of congestive heart failure (CHF)?
- Low morbidity and mortality rates
- Primary diagnosis of acutely compensated heart failure
- Decreasing incidence and prevalence
- Approximately 1 million US hospital admissions per year (correct)
How is systolic dysfunction characterized in heart failure (HF)?
How is systolic dysfunction characterized in heart failure (HF)?
- Constricted left ventricle with normal contractility
- Constricted left ventricle with impaired contractility
- Dilated left ventricle with impaired contractility (correct)
- Dilated left ventricle with relaxed muscles
Which New York Heart Association's functional classification of CHF describes a patient who is not limited with normal physical activity by symptoms?
Which New York Heart Association's functional classification of CHF describes a patient who is not limited with normal physical activity by symptoms?
- Class IV
- Class II
- Class III
- Class I (correct)
What is diastolic dysfunction in heart failure (HF) characterized by?
What is diastolic dysfunction in heart failure (HF) characterized by?
What is the primary cause of acutely decompensated heart failure?
What is the primary cause of acutely decompensated heart failure?
What does the functional classification of Class III in CHF mean?
What does the functional classification of Class III in CHF mean?
What is the prevalence rate of CHF?
What is the prevalence rate of CHF?
Which neurohormonal response is released by cardiac myocytes in response to cardiac injury?
Which neurohormonal response is released by cardiac myocytes in response to cardiac injury?
What is the leading diagnosis-related group (DRG) among hospitalized patients older than 65 years?
What is the leading diagnosis-related group (DRG) among hospitalized patients older than 65 years?
What is the 1-year survival rate after diagnosis of CHF?
What is the 1-year survival rate after diagnosis of CHF?
In pulmonary edema, what causes alveolar flooding to occur?
In pulmonary edema, what causes alveolar flooding to occur?
Which type of heart failure is characterized by decreased contractility?
Which type of heart failure is characterized by decreased contractility?
What is the ejection fraction (EF) range for heart failure with reduced ejection fraction (HFrEF)?
What is the ejection fraction (EF) range for heart failure with reduced ejection fraction (HFrEF)?
What compensatory mechanism promotes venous and arterial vasodilation, reduces preload, and reduces afterload?
What compensatory mechanism promotes venous and arterial vasodilation, reduces preload, and reduces afterload?
What does the Frank-Starling mechanism state about cardiac dilatation during diastole?
What does the Frank-Starling mechanism state about cardiac dilatation during diastole?
What is the primary cause of death in patients with heart failure?
What is the primary cause of death in patients with heart failure?
What is the main purpose of the compensation mechanisms in heart failure?
What is the main purpose of the compensation mechanisms in heart failure?
Which ethnic group has a higher likelihood of dying from CHF compared to whites?
Which ethnic group has a higher likelihood of dying from CHF compared to whites?
Which test is helpful when there is diagnostic uncertainty in heart failure and to evaluate for underlying cause?
Which test is helpful when there is diagnostic uncertainty in heart failure and to evaluate for underlying cause?
What is the initial therapy for patients with hypertensive acute heart failure?
What is the initial therapy for patients with hypertensive acute heart failure?
Which medication is contraindicated in patients with systolic blood pressure (SBP) less than 100 mm Hg?
Which medication is contraindicated in patients with systolic blood pressure (SBP) less than 100 mm Hg?
What is the goal of pharmacotherapy in the treatment of decompensated congestive heart failure (CHF) and pulmonary edema?
What is the goal of pharmacotherapy in the treatment of decompensated congestive heart failure (CHF) and pulmonary edema?
Which medication may rapidly reverse hemodynamic instability and symptoms in patients with elevated blood pressure?
Which medication may rapidly reverse hemodynamic instability and symptoms in patients with elevated blood pressure?
What is the most appropriate initial therapy if a patient presents with acute pulmonary edema with a systolic blood pressure of at least 100 mm Hg?
What is the most appropriate initial therapy if a patient presents with acute pulmonary edema with a systolic blood pressure of at least 100 mm Hg?
Which medication reduces preload and systemic vascular resistance (SVR) and increases cardiac output in acute therapy?
Which medication reduces preload and systemic vascular resistance (SVR) and increases cardiac output in acute therapy?
"To reduce venous return, elevate the head of the bed" - Which medication is most appropriate to achieve this effect?
"To reduce venous return, elevate the head of the bed" - Which medication is most appropriate to achieve this effect?
"In addition to being both an anxiolytic and an analgesic, its most important effect is venodilation, which reduces preload" - Which medication does this statement refer to?
"In addition to being both an anxiolytic and an analgesic, its most important effect is venodilation, which reduces preload" - Which medication does this statement refer to?
Which test might not always be part of the standard workup for heart failure, but can be helpful when there is diagnostic uncertainty?
Which test might not always be part of the standard workup for heart failure, but can be helpful when there is diagnostic uncertainty?
What is the initial dosing of Furosemide (Lasix) for patients symptomatic with CHF not already using diuretics?
What is the initial dosing of Furosemide (Lasix) for patients symptomatic with CHF not already using diuretics?
What is the most common cause of acute deterioration of cardiac function leading to cardiogenic shock?
What is the most common cause of acute deterioration of cardiac function leading to cardiogenic shock?
Which combination of clinical manifestations is suggestive of significant right ventricular infarction, massive pulmonary embolism, or cardiac tamponade?
Which combination of clinical manifestations is suggestive of significant right ventricular infarction, massive pulmonary embolism, or cardiac tamponade?
Which diagnostic test is particularly useful in determining the regional and global ventricular function, presence of pericardial effusion, and severe acute valvular diseases?
Which diagnostic test is particularly useful in determining the regional and global ventricular function, presence of pericardial effusion, and severe acute valvular diseases?
Which statement about the natural history of cardiogenic shock complicating acute myocardial infarction is true?
Which statement about the natural history of cardiogenic shock complicating acute myocardial infarction is true?
What is the primary therapy for cardiogenic shock directed at?
What is the primary therapy for cardiogenic shock directed at?
In the presence of cardiogenic shock due to inotropic failure of the left ventricle without profound hypotension, what should be administered to increase stroke volume?
In the presence of cardiogenic shock due to inotropic failure of the left ventricle without profound hypotension, what should be administered to increase stroke volume?
What nonpharmacologic therapy allows the heart to rest and is used for patients with cardiogenic shock?
What nonpharmacologic therapy allows the heart to rest and is used for patients with cardiogenic shock?
What is the indication for ventricular assist device (VAD) therapy?
What is the indication for ventricular assist device (VAD) therapy?
What does chronic heart failure (HF)-End Stage >ADHF refer to?
What does chronic heart failure (HF)-End Stage >ADHF refer to?
Which nonpharmacologic therapy involves wrapping the latissimus dorsi around the heart?
Which nonpharmacologic therapy involves wrapping the latissimus dorsi around the heart?
What medication should be administered only for treatment of sustained, hemodynamically significant arrhythmias due to its negative inotropic action?
What medication should be administered only for treatment of sustained, hemodynamically significant arrhythmias due to its negative inotropic action?
Which combination of clinical manifestations indicates significant right ventricular infarction, massive pulmonary embolism, or cardiac tamponade?
Which combination of clinical manifestations indicates significant right ventricular infarction, massive pulmonary embolism, or cardiac tamponade?
Which of the following is NOT a common congestive symptom of heart failure?
Which of the following is NOT a common congestive symptom of heart failure?
What is the most common dysrhythmia associated with heart failure?
What is the most common dysrhythmia associated with heart failure?
Which of the following physical findings is NOT associated with right heart failure?
Which of the following physical findings is NOT associated with right heart failure?
What is the term for the alternating weak and strong pulse indicative of depressed left ventricle function?
What is the term for the alternating weak and strong pulse indicative of depressed left ventricle function?
Which condition is characterized by acute pulmonary edema and may present with symptoms such as cool and clammy skin, tachycardia, and frothy, blood-tinged sputum?
Which condition is characterized by acute pulmonary edema and may present with symptoms such as cool and clammy skin, tachycardia, and frothy, blood-tinged sputum?
What is the most useful point-of-care test for identifying heart failure?
What is the most useful point-of-care test for identifying heart failure?
Which imaging study can assess ventricular function, size, wall motion, valve function, and help identify the etiology of heart failure?
Which imaging study can assess ventricular function, size, wall motion, valve function, and help identify the etiology of heart failure?
Which laboratory value is suggestive of a congestive hepatopathy in heart failure?
Which laboratory value is suggestive of a congestive hepatopathy in heart failure?
What is the classic pattern of pulmonary edema observed on chest radiography reflecting a pulmonary capillary wedge pressure (PCWP) of more than 25 mm Hg?
What is the classic pattern of pulmonary edema observed on chest radiography reflecting a pulmonary capillary wedge pressure (PCWP) of more than 25 mm Hg?
What is the term for the nonspecific tool that may be useful in diagnosing concomitant cardiac ischemia, prior myocardial infarction (MI), cardiac dysrhythmias, or left ventricular hypertrophy?
What is the term for the nonspecific tool that may be useful in diagnosing concomitant cardiac ischemia, prior myocardial infarction (MI), cardiac dysrhythmias, or left ventricular hypertrophy?
Which medication is recommended as a replacement for ACE inhibitors in patients with HFrEF who remain symptomatic despite optimal treatment with ACE-I, beta-blocker, and MRA?
Which medication is recommended as a replacement for ACE inhibitors in patients with HFrEF who remain symptomatic despite optimal treatment with ACE-I, beta-blocker, and MRA?
What is the primary protective effect of SGLT2 inhibitors in heart failure?
What is the primary protective effect of SGLT2 inhibitors in heart failure?
Which medication is recommended for patients with stable symptomatic HFrEF to reduce the risk of hospitalization and death?
Which medication is recommended for patients with stable symptomatic HFrEF to reduce the risk of hospitalization and death?
What is the role of beta-blockers in the acute setting for patients with heart failure?
What is the role of beta-blockers in the acute setting for patients with heart failure?
What is the primary mechanism of action of Ivabradine in heart failure?
What is the primary mechanism of action of Ivabradine in heart failure?
Which drug class is not recommended for patients with heart failure due to its association with worsening heart failure?
Which drug class is not recommended for patients with heart failure due to its association with worsening heart failure?
What is the suggested activity modification for a patient in the severe stage of heart failure?
What is the suggested activity modification for a patient in the severe stage of heart failure?
Which complication is most commonly seen in patients with significantly depressed left ventricular function?
Which complication is most commonly seen in patients with significantly depressed left ventricular function?
What is the primary hemodynamic criterion for cardiogenic shock?
What is the primary hemodynamic criterion for cardiogenic shock?
