Heart Failure

Which of the following best describes heart failure?

A patient presents with chronic anemia. Which of the following is the MOST likely classification this will fall under related to heart failure?

According to the NYHA Functional Classification, which class involves symptoms at rest?

A patient is classified as ACC/AHA Stage B heart failure. Which of the following is MOST consistent with this classification?

Which of the following is a common cause of right ventricular failure?

What physical exam finding is MOST indicative of pure right ventricular failure?

Which of the following is a symptom MOST associated with left ventricular failure?

A patient presents with shortness of breath, pulmonary edema, and paroxysmal nocturnal dyspnea. Which of the following pathophysiological processes is MOST likely?

Which of the following statements BEST describes low-output heart failure?

Which of the following physical exam finding is MOST indicative of heart failure?

What radiographic finding on a chest X-ray suggests chronic elevation of left atrial pressure in heart failure?

A patient presents with dyspnea. What is the MOST appropriate use of B-type natriuretic peptide (BNP) in this scenario?

What BNP level is MOST predictive of Congestive Heart Failure (CHF)?

When performing an echocardiogram to assess heart failure, which of the following is NOT typically evaluated?

A patient presents with labored breathing upon entering the exam room, elevated JVP, bibasilar crackles, and lower extremity edema. Which of the following physical exam findings is MOST concerning?

What is the MOST important initial step in evaluating a patient with newly diagnosed heart failure?

Which of the following best describes heart failure with preserved ejection fraction (HFpEF)?

According to the WHO, what is the proper way to determine if someone has HFpEF?

What is a hallmark finding observed in restrictive cardiomyopathy?

A patient with a history of hypertension is diagnosed with diastolic dysfunction. Which mechanism MOST likely contributes to this condition?

What echocardiogram finding is MOST suggestive of cardiac amyloidosis?

What is a characteristic feature of hypertrophic cardiomyopathy (HCM) pathophysiology?

A young athlete collapses after extreme exertion. What cardiac condition should be suspected given the increased risk of sudden cardiac death?

During a physical exam for HCM, what dynamic auscultation maneuver would increase the murmur intensity?

An echocardiogram reveals asymmetrical septal hypertrophy with a septum thickness greater than 1.3 times the thickness of the LV posterior wall, and systolic anterior motion of the mitral valve. Which condition does this support?

Which category of medication is contraindicated in hypertrophic cardiomyopathy (HCM)?

What advice should be given to patients with HCM when it comes to physical activity?

When heart failure with preserved ejection fraction (HFpEF) is suspected, which test should be performed?

Given a diagnosis of Heart Failure with Preserved Ejection Fraction (HFpEF), which of the following medications has NO proven role in treatment?

In patients with restrictive cardiomyopathy, which of the following treatments is MOST appropriate for hemochromatosis?

For which condition is consideration for surgical myomectomy or alcohol septal ablation warranted?

A patient with a history of restrictive cardiomyopathy secondary to cardiac amyloidosis may benefit from which of the following medications?

A patient presents with symptoms of heart failure but has a normal ejection fraction. What is the MOST important next step in their management?

Which of the following etiologies is MOST associated with restrictive cardiomyopathy?

A patient presents with heart failure symptoms. Their lab results show a BNP level of 300 pg/mL. What other condition can cause the elevated BNP besides CHF?

A patient presents for a follow-up appointment and admits that they have not taken their medications due to the cost. They have stage D heart failure (refractory HF requiring specialized interventions). What is the BEST course of action?

A 72-year-old male is admitted with dyspnea on exertion and lower extremity edema. His medical history includes hypertension, hyperlipidemia, and type 2 diabetes. An echocardiogram reveals a normal ejection fraction (60%) but also shows left ventricular hypertrophy and impaired diastolic filling. His BNP is elevated at 600 pg/mL. Which of the following is the MOST appropriate initial management strategy?

Which of the following is NOT typically associated with high-output heart failure?

A patient presents with heart failure symptoms. The physician notes the presence of an S4 heart sound. Which type of heart failure is MOST suggested by this finding?

Which of the following is a typical symptom of pure left ventricular failure?

A patient with known heart failure presents to the emergency department with acute respiratory distress. Which physical exam finding would be MOST concerning?

Which of the following chest X-ray findings is indicative of CHF?

What is the MOST common cause of right heart failure?

A patient's echocardiogram reveals normal left ventricular systolic function, but also shows concentric hypertrophy. What is the MOST likely underlying cause?

Which condition is associated with 'bronze diabetes'?

What is the typical method of diagnosing HFpEF?

A patient with hypertrophic cardiomyopathy experiences increased murmur intensity upon standing from a squatting position. What explains this phenomenon?

A 60-year-old male presents with dyspnea on exertion. His BNP level is 400 pg/mL. Which of the following conditions could be contributing to his elevated BNP?

A young athlete collapses suddenly during a basketball game. ECG shows left ventricular hypertrophy. What condition is MOST suspected?

A patient with restrictive cardiomyopathy shows signs of hemochromatosis. Which treatment is MOST appropriate?

A patient is diagnosed with restrictive cardiomyopathy due to cardiac amyloidosis. What echocardiogram finding is MOST suggestive of this diagnosis?

Which of the following factors contributes to the development of diastolic dysfunction in patients with hypertension?

What is the normal ejection fraction?

Which of the following medication classes is contraindicated in patients with hypertrophic cardiomyopathy (HCM)?

Which of the following is the MOST appropriate initial step in evaluating a 55-year-old patient with newly diagnosed heart failure?

Which statement is true regarding surgical therapies for hypertrophic cardiomyopathy?

Which of the following best describes the physiological change that leads to heart failure with reduced ejection fraction (HFrEF)?

A patient with longstanding uncontrolled hypertension is most likely to develop which type of heart failure?

Which of the following is a common early symptom in patients presenting with either HFrEF or HFpEF?

A patient with HFrEF is being evaluated for an implantable cardioverter-defibrillator (ICD). According to guidelines, what is the minimum duration of optimal medical therapy that should be trialed before ICD consideration for primary prevention in ischemic cardiomyopathy?

Which of the following is a known cause of non-ischemic dilated cardiomyopathy?

A patient is diagnosed with peripartum cardiomyopathy. Which of the following statements regarding this condition is MOST accurate?

Which of the following metabolic derangements is associated with the development of non-ischemic dilated cardiomyopathy?

A patient with a history of supraventricular tachycardia (SVT) presents with symptoms of heart failure. What aspect of the SVT is MOST directly correlated with the degree of cardiac dysfunction?

In the management of HFrEF, what is the primary rationale for dietary sodium restriction?

A patient with HFrEF experiences persistent volume overload despite optimal doses of ACE inhibitors and beta-blockers. Which class of medication is MOST appropriate to address this?

Which of the following electrolyte abnormalities is a known potential side effect of loop diuretics, such as furosemide, when used in patients with HFrEF?

Which of the following is the MOST important consideration when initiating beta-blockers in a patient with HFrEF?

Which of the following is a potential adverse effect associated with mineralocorticoid receptor antagonists (MRAs) such as spironolactone, requiring careful monitoring?

A patient with HFrEF and a history of angioedema while taking an ACE inhibitor needs an afterload reducing agent. Which of the following medications is contraindicated?

A patient with HFrEF is already on an ACE inhibitor. Under what circumstances is it appropriate to switch them to an ARNI?

According to current guidelines, which of the following medication classes provides mortality benefit for patients with HFrEF, irrespective of diabetes status?

Which of the following best describes the established effect of digoxin in the management of HFrEF?

For which of the following HFrEF patients should anticoagulation with warfarin be considered?

An African American patient with moderate-severe heart failure symptoms despite being on an ACE inhibitor, beta-blocker, and diuretic, may benefit from the addition of which of the following?

According to current guidelines, which patient with dilated cardiomyopathy would be a candidate for an implantable cardioverter defibrillator (ICD) for primary prevention of sudden cardiac death?

A patient presents with heart failure symptoms and an ejection fraction of 30%. Their QRS duration on ECG is 130 msec, and they are in NYHA functional class III. What device therapy should be considered?

What is the MOST appropriate initial management strategy of newly diagnosed heart failure?

Aside from ACE-I, ARB or ARNI, Beta-blocker, MRA and SGLT2i, what other lifestyle change could significantly affect heart failure patients?

In the pathophysiology of heart failure, describe the neuroendocrine response of the body.

Aside for reduced ejection fraction, what are other typical signs and symptoms of dilated cardiomyopathy?

The following is the definition of HFrEF:

Which of the following etiologies is MOST associated with HFrEF?

What are the three medications that requires additional clinical trials?

What is the mechanism of action of ACE inhibitors in management of cardiovascular hemodynamics?

What is the indication for use for Ivabradine (Corlanor)?

What is the importance of ACE-I, ARB, or ARNI, Beta-blocker, MRA, and SGLT2i?

Chronic alcoholism may lead to non-ischemic dilated cardiomyopathy due to what affects?

Tachycardia induced cardiomyopathy is an example of rapidly increased ventricular response. What is the degree of disfunction dependent on?

SGLT2i are recently useful for treating heart failure regardless of which of the other factors?

Beta blockers are common for use in many patients, however the titration method requires the provider to be extra cautious. What is the proper method?

What are important contraindications of ACE inhibitors?

Compared to HFrEF, HFpEF often occurs dur to:

Which of the following best characterizes ACC/AHA Stage A heart failure?

Which of the following can result from non-ischemic cardiomyopathy?

Which of the following statements may be true regarding familial or dilated cardiomyopathy?

Which of the following is the MOST likely reason to experience atrial regurgitation?

A patient with HFrEF presents with a potassium level of 5.4 mEq/L and a creatinine level of 2.6 mg/dL. Which of the following medications should be avoided?

Heart failure with reduced ejection fraction (HFrEF) is clinically defined by a left ventricular ejection fraction (LVEF) of what percentage or less?

Which of the following conditions is MOST commonly associated with the etiology of ischemic dilated cardiomyopathy, leading to heart failure with reduced ejection fraction (HFrEF)?

According to current guidelines for heart failure with reduced ejection fraction (HFrEF), which of the following medication classes is considered part of the 'quad therapy' known to provide mortality benefit?

A patient with heart failure with reduced ejection fraction (HFrEF) is being considered for an angiotensin receptor-neprilysin inhibitor (ARNI). Which of the following historical findings would be a CONTRAINDICATION for initiating ARNI therapy?

In the management of tachycardia-induced cardiomyopathy leading to HFrEF, the degree of cardiac dysfunction is MOST directly correlated with which factor related to the tachyarrhythmia?

Which of the following best explains the underlying cause of alveolar congestion in acute decompensated heart failure (ADHF)?

A patient with ADHF is being evaluated. Which of the following is MOST important to rule out promptly?

Which of the following medication classes, if newly started, is MOST likely to exacerbate heart failure?

A patient with ADHF is being treated with intravenous diuretics but remains significantly congested. Their blood pressure is adequate. Which of the following would be MOST appropriate to add to their treatment regimen?

In the management of ADHF, what is the typical goal for fluid balance when monitoring fluid intake and output for patients with HFpEF?

Which of the following is the MOST significant concern when using positive inotropes in patients with severe ADHF?

A patient with ADHF and a history of asthma requires an inotropic agent. Which of the following would be the MOST appropriate choice?

A patient is admitted with ADHF and has a history of hypertension. Which of the following blood pressure readings would contraindicate the use of intravenous beta-blockers?

Which of the following is the MOST appropriate approach for discontinuing loop diuretics in a patient who has had ADHF while also managing hypokalemia?

During an episode of ADHF, a patient develops acute respiratory failure. Which of the following physiological changes is MOST likely contributing to this condition?

Which of the following instructions should be given to a patient being discharged after hospitalization for ADHF?

A patient with ADHF is being discharged on a loop diuretic and ACE inhibitor. What electrolyte abnormality should be MOST closely monitored?

A patient with ADHF has persistent hypotension despite adequate filling pressures. Which of the following medications is MOST appropriate as a temporizing measure?

A patient presents with signs and symptoms indicative of ADHF. After initial stabilization, which diagnostic test is MOST crucial to determine long term management?

Which of the following vital sign changes is the MOST concerning for a patient admitted for ADHF?

Which of the following best describes the underlying cause of alveolar congestion in acute decompensated heart failure (ADHF)?

A patient with ADHF is being evaluated in the emergency department. What is the MOST important differential diagnosis to rule out promptly?

A patient who has ADHF is being discharged. Which of the following instructions should be emphasized?

What is the MOST important consideration when discontinuing loop diuretics in a patient who has had ADHF?

What is the typical goal for fluid management (daily intake and output) when treating ADHF in someone who has HFpEF?

A patient requires an inotropic agent during an acute decompensated heart failure (ADHF) episode, and also has a history of asthma. Which of the following would be the MOST appropriate choice?

A patient with ADHF and a history of hypertension requires an inotropic agent. Which of the following blood pressure readings is a contraindication for intravenous beta-blockers?

When should intravenous vasodilators be considered in ADHF management?

What is the recommended daily goal for fluid output in patients with HFpEF who are being managed for ADHF?

A patient returns for follow-up two weeks after being discharged for ADHF. He is taking a loop diuretic and ACE-I. What electrolyte abnormality should be MOST closely monitored on follow-up?

A patient presents with signs and symptoms indicative of ADHF. After initial stabilization, which diagnostic test is MOST crucial and will affect long-term management going forward?

A 74-year-old woman with hypertension and dyspnea on exertion is found to have a normal ejection fraction and concentric left ventricular hypertrophy on echocardiogram. What is the most likely diagnosis?

A 68-year-old male with known systolic heart failure presents with worsening dyspnea, orthopnea, and elevated JVP. His EF is 30%. Which of the following medications is most likely to reduce mortality in this patient?

A 55-year-old woman develops acute shortness of breath following a stressful event. EKG shows ST changes; troponin is elevated. Cath shows no coronary obstruction, but echo reveals apical ballooning. What is the most likely diagnosis?

A hospitalized patient with HFrEF is being treated with high-dose loop diuretics. He develops dizziness and hypotension. Which of the following is the most likely explanation?

A 76-year-old woman presents with bibasilar rales, 3+ leg edema, JVD, and an S3. BNP is >900. Which of the following CXR findings is most consistent with this clinical picture?

A patient presents in acute decompensated heart failure with pulmonary edema. Which of the following medications should be avoided initially?

A patient with HFpEF is being treated with furosemide for volume overload. Which of the following additional therapies has shown benefit in reducing hospitalization in appropriately selected patients?

A 65-year-old male with HFrEF (EF 28%) is stable on carvedilol, furosemide, and lisinopril. Which additional medication provides mortality benefit and is part of the guideline-directed quad therapy?

A 70-year-old man with nonischemic cardiomyopathy (EF 25%) is on maximal therapy. His EKG shows a QRS duration of 140 msec and NYHA Class III symptoms. What is the next best step?

A 60-year-old female is admitted with dyspnea. Echo shows EF 25%. Which of the following drugs improves symptoms but does not reduce mortality?

A 42-year-old woman with recent twins develops symptoms of heart failure 1 month after delivery. Echo shows EF 35%. What is the most likely diagnosis?

A 36-year-old man collapses after playing basketball. He had a known murmur on prior exams. Autopsy reveals asymmetric septal hypertrophy. What could have prevented his death?

A 55-year-old male with amyloidosis presents with signs of right-sided heart failure. Echo shows diastolic dysfunction and a speckled myocardium. Which of the following is the most appropriate treatment?

A patient with NYHA Class III HFrEF and EF 30% presents for follow-up. Despite optimized medication therapy, they remain symptomatic. Which of the following is a surgical option to improve outcomes?

A 59-year-old man with HFrEF is taking ACE-I, metoprolol, and furosemide. His EF remains <35%. What medication, if added, further improves survival and also works in non-diabetics?

A 72-year-old male with HFrEF is admitted for acute decompensated heart failure. Which of the following loop diuretic strategies is most appropriate on admission?

A 68-year-old female presents with acute HF exacerbation. She has hypotension (SBP 85), cool extremities, elevated JVP, and rales. Which of the following agents is contraindicated in her current state?

A patient with decompensated heart failure remains dyspneic despite IV furosemide. He is hypertensive (BP 165/100). Which is the most appropriate next step?

A 60-year-old woman presents with chest pain after a sudden emotional stressor. EKG shows ST elevations. Cath shows no CAD. Echo shows apical ballooning. What is the treatment?

Which of the following is a major risk with prolonged use of nitroprusside in treating acute heart failure?

A 59-year-old male with ADHF is on high-dose diuretics but remains fluid-overloaded. Which of the following is an appropriate adjunct therapy?

A 71-year-old male is hospitalized with acute heart failure. He receives furosemide and loses 4 liters net. He later complains of dizziness and weakness. Which lab abnormality is most likely?

A 65-year-old female is admitted with worsening HF. Echo shows LVEF 60%, concentric hypertrophy, and restrictive filling. BNP is elevated. What's the diagnosis?

Which of the following is another name for Takotsubo cardiomyopathy?

A patient presents with chest pain and is suspected of having acute coronary syndrome. A coronary angiogram is performed and shows no significant blockages. An echocardiogram reveals apical ballooning. Which of the following is the MOST likely diagnosis?

Which of the following ECG changes is MOST likely to be observed in a patient with Takotsubo cardiomyopathy?

A 68-year-old female presents to the emergency department with chest pain and shortness of breath following the unexpected death of her spouse. Her ECG shows ST-segment elevations in the precordial leads. Cardiac catheterization reveals no coronary artery obstruction. An echocardiogram demonstrates left ventricular apical ballooning. Which of the following is the MOST likely underlying cause of this condition?

Which of the following is the MOST accurate statement regarding the treatment of Takotsubo cardiomyopathy?

In which population is Takotsubo cardiomyopathy MOST commonly observed?

A 62-year-old woman presents with symptoms suggestive of acute coronary syndrome. Coronary angiography reveals no significant obstruction. Echocardiography shows apical ballooning of the left ventricle. What is the MOST appropriate next step in management?

A patient diagnosed with Takotsubo cardiomyopathy asks about the likelihood of experiencing this condition again. Which of the following is the MOST accurate statement you can provide?

A patient is diagnosed with Takotsubo cardiomyopathy after experiencing severe emotional distress. Which of the following pathophysiological mechanisms is LEAST likely to contribute to the development of this condition?

A 55-year-old female presents to the ED with symptoms consistent with Takotsubo cardiomyopathy including chest pain, dyspnea, and apical ballooning upon echocardiogram. During the work-up, the patient shares a history of panic disorder managed with alprazolam. Extensive literature review reveals isolated case reports suggesting a correlation between benzodiazepines and Takotsubo cardiomyopathy due to potential effects on autonomic nervous system and myocardial calcium handling, BUT these findings are far from conclusive and evidence is limited. What is the MOST appropriate, evidence-based course of action regarding her alprazolam prescription, acknowledging the uncertainty?