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4.4 CARDIAC

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40 Questions

What is the primary mechanism of diastolic heart failure?

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

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

Systolic heart failure with reduced ejection fraction

What is the most common cause of right heart failure?

Left heart failure

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

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

All of the above

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

Decreased ejection fraction due to impaired systolic function

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

Left ventricular hypertrophy

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

About 1% of the population

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

Increased stroke volume but increased workload leading to hypertrophy

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

Decreased renal blood flow and increased RAAS activation

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

Down-regulation of β-adrenergic receptors

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

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

Decreased stroke volume and increased workload

Why is heart rate controlled in diastolic heart failure?

To avoid further decreases in ventricular filling and allow adequate time to fill

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

Reverse the remodeling process

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

Most commonly a result of ischemic injury

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

Liver congestion and prerenal azotemia

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

Increased lung water

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

Intermediate probability

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

Echocardiography

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

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

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

Impairs breakdown of BNP, making levels inaccurate

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

Can be difficult to assess due to sedentary lifestyle

What is the timeframe during which dilated cardiomyopathy typically occurs?

From the 3rd trimester to approximately 5 months postpartum

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

ACE Inhibitors

What is the primary pathophysiological mechanism underlying restrictive cardiomyopathy?

Decreased compliance of the ventricle

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

Amyloidosis

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

Maintenance of sinus rhythm

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

Normal systolic function

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

Potential for re-infiltration of the new heart

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

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

Increase contractility

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

Neprilysin inhibition

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

Ivabradine

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

Systolic anterior motion (SAM)

What is the most common cause of heart failure?

Ischemic heart disease

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

Desflurane

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

Reducing hospitalization for heart failure

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

Peripartum cardiomyopathy

Test your knowledge of heart failure, its etiology, and the differences between systolic and diastolic heart failure. Learn about the epidemiology and demographics of heart failure, including its prevalence in different age groups and genders.

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