4.4 CARDIAC

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What is the primary mechanism of diastolic heart failure?

Decreased ejection fraction due to ischemic injury

Increased systolic pressure due to chronic hypertension

Impaired relaxation due to decreased Ca++ uptake by the sarcoplasmic reticulum (correct)

Reduced contractility due to decreased beta-adrenergic stimulation

Which type of heart failure is more common in males at an earlier age?

Right heart failure

Left heart failure

Diastolic heart failure

Systolic heart failure with reduced ejection fraction (correct)

What is the most common cause of right heart failure?

Chronic hypertension

Left heart failure (correct)

Left ventricular hypertrophy

Pulmonary embolism

What is the primary difference between systolic and diastolic heart failure?

Systolic HF has a reduced ejection fraction, while diastolic HF has a preserved ejection fraction Signup and view all the answers

Which of the following is a common cause of systolic heart failure?

All of the above Signup and view all the answers

What is the primary characteristic of systolic heart failure with reduced ejection fraction?

Decreased ejection fraction due to impaired systolic function Signup and view all the answers

What is the result of pressure overload on the left ventricle?

Left ventricular hypertrophy Signup and view all the answers

What is the incidence of heart failure in the population over 65 years old?

About 1% of the population Signup and view all the answers

What is the primary effect of increased LVEDV and LVEDP on the failing heart?

Increased stroke volume but increased workload leading to hypertrophy Signup and view all the answers

Which of the following is a result of SNS activation in heart failure?

Decreased renal blood flow and increased RAAS activation Signup and view all the answers

What is the effect of high plasma NE levels on β-adrenergic receptors in heart failure?

Down-regulation of β-adrenergic receptors Signup and view all the answers

What is the primary mechanism by which the myocardium attempts to compensate for the decreased cardiac output in heart failure?

Increased secretion of ANP and BNP Signup and view all the answers

What is the primary effect of increased afterload on the failing heart?

Decreased stroke volume and increased workload Signup and view all the answers

Why is heart rate controlled in diastolic heart failure?

To avoid further decreases in ventricular filling and allow adequate time to fill Signup and view all the answers

What is the effect of ACE Inhibitors on the remodeling process in heart failure?

Reverse the remodeling process Signup and view all the answers

What is the result of the body's compensatory mechanisms to maintain cardiac output in heart failure?

Most commonly a result of ischemic injury Signup and view all the answers

What is the primary cause of anorexia, nausea, and abdominal pain in heart failure patients?

Liver congestion and prerenal azotemia Signup and view all the answers

A patient with heart failure is experiencing dyspnea. What is the most likely cause of this symptom?

Increased lung water Signup and view all the answers

A patient's BNP levels are measured to be 400 pg/ml. What is the probability of heart failure in this patient?

Intermediate probability Signup and view all the answers

What is the gold standard for diagnosing heart failure, but is not required every time?

Echocardiography Signup and view all the answers

A patient with heart failure is experiencing tachypnea, basilar rales, and tachycardia. What type of heart failure is this patient most likely experiencing?

LV failure Signup and view all the answers

A patient with heart failure is classified as New York Heart Association Class III. What is the characteristic of this patient's symptoms?

Symptoms occur with less than ordinary activity Signup and view all the answers

What is the primary mechanism by which Entresto therapy affects BNP levels?

Impairs breakdown of BNP, making levels inaccurate Signup and view all the answers

What is the characteristic of fatigue and weakness in heart failure patients?

Can be difficult to assess due to sedentary lifestyle Signup and view all the answers

What is the timeframe during which dilated cardiomyopathy typically occurs?

From the 3rd trimester to approximately 5 months postpartum Signup and view all the answers

Which of the following medications is contraindicated in the treatment of dilated cardiomyopathy?

ACE Inhibitors Signup and view all the answers

What is the primary pathophysiological mechanism underlying restrictive cardiomyopathy?

Decreased compliance of the ventricle Signup and view all the answers

Which of the following systemic diseases can produce myocardial infiltration and lead to restrictive cardiomyopathy?

Amyloidosis Signup and view all the answers

What is the primary anesthetic management goal in patients with restrictive cardiomyopathy?

Maintenance of sinus rhythm Signup and view all the answers

What is the typical characteristic of systolic function in restrictive cardiomyopathy?

Normal systolic function Signup and view all the answers

What is the primary reason for avoiding heart transplantation in patients with restrictive cardiomyopathy?

Potential for re-infiltration of the new heart Signup and view all the answers

What is the physiological effect of the reduction in gradient across the aortic valve after opening or repair of the aortic valve?

Mid-cavitary collapse of the LV and inability to eject Signup and view all the answers

Which of the following is NOT a primary goal of anesthetic management in hypertrophic cardiomyopathy?

Increase contractility Signup and view all the answers

What is the primary mechanism of action of sacubitril in sacubitril/valsartan?

Neprilysin inhibition Signup and view all the answers

Which of the following medications is NOT recommended in the treatment of heart failure with preserved ejection fraction?

Ivabradine Signup and view all the answers

What is the term for the anterior movement of the mitral valve during systole in hypertrophic cardiomyopathy?

Systolic anterior motion (SAM) Signup and view all the answers

What is the most common cause of heart failure?

Ischemic heart disease Signup and view all the answers

Which of the following anesthetic agents is LEAST likely to exacerbate left ventricular outflow tract obstruction in hypertrophic cardiomyopathy?

Desflurane Signup and view all the answers

What is the primary benefit of ivabradine in heart failure with reduced ejection fraction?

Reducing hospitalization for heart failure Signup and view all the answers

What is the term for the type of cardiomyopathy that occurs in the peripartum period?

Peripartum cardiomyopathy Signup and view all the answers