Heart Failure Overview Quiz
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Questions and Answers

What characterizes Systolic Heart Failure?

  • Increased heart muscle stiffness
  • Reduced ejection fraction (EF < 40%) (correct)
  • Inadequate filling of blood
  • Preserved ejection fraction (EF > 50%)

    • Which type of heart failure is characterized by pulmonary congestion?

  • Right-Sided Heart Failure
  • Chronic Heart Failure
  • Left-Sided Heart Failure (correct)
  • Acute Heart Failure Syndrome

    • What is the primary reason for developing Chronic Heart Failure?

  • Sudden heart muscle weakening
  • Inadequate filling of blood
  • Rapid onset of symptoms
  • Underlying cardiovascular diseases (correct)

    • Acute Heart Failure Syndrome (AHF) requires what kind of therapy?

    <p>Urgent therapy</p> Signup and view all the answers

    What type of heart failure is associated with a preserved ejection fraction?

    <p>Diastolic Heart Failure</p> Signup and view all the answers

    What is the most common cause of Right-Sided Heart Failure?

    <p>Left-Sided Heart Failure</p> Signup and view all the answers

    Congestive Heart Failure (CHF) can affect which aspect of heart function?

    <p>Both sides of the heart</p> Signup and view all the answers

    Excessive body needs, such as those seen in anemia, can lead to which condition?

    <p>Heart Failure</p> Signup and view all the answers

    What symptom would you expect to be elevated in congestive cardiac failure (CCF)?

    <p>Jugular venous pressure</p> Signup and view all the answers

    Which characteristic of the pulse may suggest left ventricular failure?

    <p>Rapid, weak, and thready</p> Signup and view all the answers

    What is a common symptom associated with right-sided heart failure?

    <p>Hepatic congestion</p> Signup and view all the answers

    What condition is associated with a diffuse apex beat?

    <p>Enlarged left ventricle</p> Signup and view all the answers

    Which of the following tests is NOT typically used to assess heart failure?

    <p>Skin Biopsy</p> Signup and view all the answers

    Which type of heart sound is referred to as a gallop rhythm when combined with tachycardia?

    <p>Third and fourth heart sounds</p> Signup and view all the answers

    What is the appearance of peripheral edema in heart failure?

    <p>Tender and extends up the legs</p> Signup and view all the answers

    What indicates a potential fluid retention issue in heart failure patients?

    <p>Peripheral Edema</p> Signup and view all the answers

    Atrial septal defects are categorized under which condition?

    <p>Congenital heart disease</p> Signup and view all the answers

    Which of the following signs is typical for low cardiac output?

    <p>Cool, clammy skin</p> Signup and view all the answers

    What is a possible consequence of GIT congestion due to heart failure?

    <p>Anorexia</p> Signup and view all the answers

    Which symptom is commonly associated with pulmonary congestion due to left-sided heart failure?

    <p>Bilateral basal fine end-inspiratory crepitations</p> Signup and view all the answers

    Which laboratory test is used to assess the severity of heart failure?

    <p>B-type Natriuretic Peptide (BNP)</p> Signup and view all the answers

    What is a prominent feature of an echocardiogram in heart failure diagnosis?

    <p>Left ventricular ejection fraction (LVEF)</p> Signup and view all the answers

    Which symptom is not commonly linked to systemic congestion in right-sided heart failure?

    <p>Sore throat</p> Signup and view all the answers

    What indicates the presence of left ventricular hypertrophy (LVH)?

    <p>A sum of greater than 35 mm</p> Signup and view all the answers

    What is the primary use of coronary angiography?

    <p>To evaluate coronary anatomy in certain patients</p> Signup and view all the answers

    Which medication is classified as a mineralocorticoid receptor antagonist (MRA)?

    <p>Spironolactone</p> Signup and view all the answers

    Which condition is NOT treated with cardiac catheterization?

    <p>Heart failure from pneumonia</p> Signup and view all the answers

    What is the main effect of ivabradine on heart function?

    <p>Decreases resting heart rate</p> Signup and view all the answers

    What does RAS activation indicate in heart failure?

    <p>Early progression of heart failure</p> Signup and view all the answers

    What is a significant contraindication for digitalis use?

    <p>Severe decompensated heart failure</p> Signup and view all the answers

    Which new method is utilized for cardiac resynchronization therapy?

    <p>Biventricular pacing</p> Signup and view all the answers

    What condition occurs when the heart muscle thickens abnormally, making it harder for the left ventricle to pump blood?

    <p>Hypertrophic Cardiomyopathy</p> Signup and view all the answers

    Which condition is characterized by narrowing of the mitral valve that restricts blood flow into the left ventricle?

    <p>Mitral Stenosis</p> Signup and view all the answers

    Which type of cardiomyopathy leads to an enlarged and weakened left ventricle?

    <p>Dilated Cardiomyopathy</p> Signup and view all the answers

    What results from narrowing of the aortic valve that forces the left ventricle to work harder?

    <p>Aortic Stenosis</p> Signup and view all the answers

    How does a heart attack impact the heart muscle?

    <p>Blocks blood flow leading to muscle damage</p> Signup and view all the answers

    Which condition increases pressure in the left atrium due to valve dysfunction, possibly leading to heart failure?

    <p>Mitral Regurgitation</p> Signup and view all the answers

    What is the mechanism behind pulmonary hypertension affecting the right ventricle?

    <p>Requires the right ventricle to work harder</p> Signup and view all the answers

    Study Notes

    Clinical Aspect of Heart Failure

    • Heart failure (HF) is a common clinical syndrome with symptoms caused by impaired heart ability to pump blood at a rate proportional to the metabolizing tissues' needs. This is due to either a structural or functional cardiac disorder.
    • Heart failure is a common end point for many cardiovascular system diseases.
    • Acute Heart Failure Syndrome (AHF) is the rapid onset or worsening of heart failure symptoms, requiring urgent therapy. It may develop in patients with previously diagnosed heart failure or manifest as the initial presentation of heart failure.
    • Chronic Heart Failure (CHF) is a long-term condition where the heart cannot pump blood efficiently to meet the body's needs. It develops slowly over time, often resulting from underlying cardiovascular diseases.

    Pathophysiology

    • Forward Failure: Characterized by low cardiac output.
    • Backward Failure: Characterized by the heart's failure to accept venous return, leading to pulmonary and systemic congestion.

    Types of Heart Failure

    • Systolic Heart Failure (HFrEF): The heart muscle is weak and cannot effectively pump blood. Characterised by a reduced ejection fraction (EF < 40%). Commonly caused by conditions like coronary artery disease and heart attacks.
    • Diastolic Heart Failure (HFpEF): The heart muscle is stiff and cannot relax properly, affecting the filling of blood. Ejection fraction is preserved (EF > 50%). Often associated with hypertension, aging, and diabetes.

    Left-Sided vs. Right-Sided Heart Failure

    • Left-Sided Heart Failure: The most common type of heart failure. The left ventricle cannot pump blood efficiently to the body, which leads to pulmonary congestion.
      • Subtypes: Systolic failure (reduced ejection fraction), Diastolic failure (preserved ejection fraction).
    • Right-Sided Heart Failure: The right ventricle fails to pump blood effectively to the lungs, leading to fluid retention in the lower extremities, abdomen, and other organs. Often a result of left-sided heart failure or pulmonary hypertension.

    Congestive Heart Failure (CHF)

    • CHF affects both sides of the heart and is characterized by fluid accumulation throughout the body.

    Causes of Heart Failure

    • Normal heart forced to do excessive work: Excessive pressure (hypertension), excessive volume (aortic regurgitation), and excessive body needs (anemia).
    • Diseased heart muscle: Cardiomyopathy.
    • Combined excessive work and heart muscle disease.

    Causes of Left-Sided Heart Failure

    • Coronary Artery Disease (CAD): The most common cause.
    • Hypertension (High Blood Pressure): Chronic high blood pressure forces the left ventricle to work harder.
    • Heart Attack (Myocardial Infarction): Blood flow blockage to part of the heart muscle.

    Causes of Right-Sided Heart Failure

    • Left-Sided Heart Failure: The most common cause.
    • Pulmonary Hypertension: High blood pressure in the lungs' arteries.
    • COPD (Chronic Obstructive Pulmonary Disease)
    • Pulmonary Embolism
    • Right Ventricular Myocardial Infarction
    • Tricuspid Valve Disease
    • Congenital Heart Disease

    Signs of Left-Sided Heart Failure

    • Low Cardiac Output Signs: Tachypnea, cyanosis, tachycardia, cool, clammy skin, intermittent claudication.
    • Lung Congestive Signs: Dyspnea, paroxysmal nocturnal dyspnea, orthopnea, acute pulmonary edema, cough, recurrent winter bronchitis, hemoptysis.

    Signs of Right-Sided Heart Failure

    • Low COP Symptoms: Low cardiac output (general symptoms).
    • Systemic Congestive Symptoms: Pain in the right upper abdomen (hepatic congestion), digestive issues (anorexia, nausea, vomiting, dyspepsia), CNS congestion (confusion, headache, insomnia, lack of memory and encephalopathy in advanced heart failure), edema in the lower limbs, ascites.

    Examination of Patients with Heart Failure

    • Cardiovascular System: Pulse (rapid, weak, thready), abnormal pulse character, blood pressure (normal, low, high). Jugular venous pressure, apex beat location and character. Heart sounds (third/fourth heart sound).
    • Respiratory System: Cyanosis, bilateral basal fine end-inspiratory crepitations, pleural effusions, and expiratory wheeze (secondary to cardiac asthma).

    Investigations of HF

    • History and Physical Examination
    • Blood Tests: CBC, Renal Function (Urea, Creatinine), Liver Function Tests, Thyroid Function, Electrolytes; B-type Natriuretic Peptide (BNP) and N-terminal pro-BNP (NT-proBNP)
    • ECG
    • CXR
    • Echo/Doppler
    • Coronary Angiography
    • Cardiopulmonary Exercise Testing (CPET)
    • Cardiac catheterization

    Treatment of Heart Failure

    • Pharmacological: Diuretics, RAS inhibitors, Digoxin, Beta-blockers, New drugs,
    • Non-Pharmacological: Diet and activity changes (salt restriction, fluid restriction, daily weight monitoring, gradual exercise programs).
    • Correction of Reversible Causes: Ischemia, valvular heart disease, thyrotoxicosis, arrhythmias
    • Anticoagulation (coumadine): For atrial fibrillation, history of embolic episodes, and left ventricular apical thrombus.
    • New drugs: Ivabradine, Sacubitril-valsartan
    • New methods: Biventricular pacing, ICD (Implantable cardioverter-defibrillator), Cardiac transplant.

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    Heart Failure PDF

    Description

    Test your knowledge on heart failure, including its types, characteristics, and symptoms. This quiz covers essential concepts related to systolic heart failure, pulmonary congestion, and chronic heart failure causes. Perfect for medical students and healthcare professionals looking to reinforce their understanding of cardiac conditions.

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