Investigation of Acute Heart Failure

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson
Download our mobile app to listen on the go
Get App

Questions and Answers

Which of the following conditions can cause heart failure?

  • Cardiomyopathies
  • Drugs
  • Toxins
  • Endocrine conditions
  • All of the above (correct)

What is the recommended maximum daily dose of sodium nitroprusside for people with acute heart failure without incremental improvement in diuresis?

  • There is no maximum dose (correct)
  • 25mg OD
  • 10mg OD
  • 50mg OD

In a person presenting with acute heart failure who is already taking beta-blockers, continue the beta-blocker treatment unless they have a heart rate less than 50 beats per minute, second or third degree atrioventricular block, or shock. When should you start or restart beta blocker treatment during hospital admission in people with acute heart failure due to left ventricular systolic dysfunction, once their condition has been stabilised?

  • When the patient has been discharged from the hospital
  • Immediately
  • For a maximum of 25-50mg BD
  • When intravenous diuretics are no longer needed (correct)

Offer an angiotensin-converting enzyme inhibitor (angiotensin receptor blocker if intolerant) and an aldosterone antagonist during hospital admission if the left ventricular ejection fraction is not tolerated.

<p>False (B)</p> Signup and view all the answers

What is the recommended maximum daily dose of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker ?

<p>10mg OD (D)</p> Signup and view all the answers

Ensure that the person's condition is stable for typically 48 hours after starting or restarting beta blockers and before discharging from the hospital.

<p>True (A)</p> Signup and view all the answers

Check daily weight, BP and pulse every 6hrs and repeat chest x-ray.

<p>True (A)</p> Signup and view all the answers

Convert diuretic dose to oral dose and stabilise.

<p>True (A)</p> Signup and view all the answers

A follow-up clinical assessment should be undertaken by a member of the specialist heart failure team within 2 weeks of the person being discharged from hospital.

<p>True (A)</p> Signup and view all the answers

Refer patients with suspected heart failure and previous myocardial infarction (MI) urgently, to have transthoracic Doppler 2D echocardiography and specialist assessment within 2 weeks. What is the other investigation recommended?

<p>All of the above (D)</p> Signup and view all the answers

Which of the following are standard investigations for people presenting with new suspected acute heart failure?

<p>All of the above (G)</p> Signup and view all the answers

Which of the following is a standard blood test for suspected acute heart failure?

<p>All of the above (G)</p> Signup and view all the answers

In people presenting with new suspected acute heart failure, use a single measurement of serum natriuretic peptides (B-type natriuretic peptide or N-terminal pro-B-type natriuretic peptide) and the following thresholds to rule out the diagnosis of heart failure.

<p>True (A)</p> Signup and view all the answers

Which of the following is a natriuretic peptide threshold used to rule out heart failure?

<p>Both A and B (C)</p> Signup and view all the answers

In people presenting with new suspected acute heart failure with raised natriuretic peptide levels, perform transthoracic Doppler 2D echocardiography to establish the presence or absence of cardiac abnormalities.

<p>True (A)</p> Signup and view all the answers

In people presenting with new suspected acute heart failure, consider performing transthoracic Doppler 2D echocardiography within 48 hours of admission to guide early specialist management.

<p>True (A)</p> Signup and view all the answers

Do not routinely offer pulmonary artery catheterisation to people with acute heart failure.

<p>True (A)</p> Signup and view all the answers

What is the initial treatment for people with suspected acute heart failure?

<p>Both A and B (B)</p> Signup and view all the answers

Administer oxygen before investigation.

<p>True (A)</p> Signup and view all the answers

Flashcards

NYHA Classification

A classification system for heart failure based on the patient's symptoms and limitations of physical activity.

Orthopnea

Shortness of breath when lying down.

Paroxysmal nocturnal dyspnea

Sudden shortness of breath that wakes a patient up from sleep.

Nocturnal cough

Coughing, often accompanied by a pink, frothy sputum, that occurs at night.

Signup and view all the flashcards

Nocturia

Waking up in the middle of the night to urinate.

Signup and view all the flashcards

Acute Heart Failure

A medical emergency where there is a new onset or worsening of chronic heart failure, characterized by fluid buildup in the lungs and/or body.

Signup and view all the flashcards

JVP

Jugular venous pressure, a measurement of pressure in the neck veins, which can be elevated in heart failure.

Signup and view all the flashcards

Pulmonary Edema

Fluid buildup in the lungs, often caused by heart failure.

Signup and view all the flashcards

Transthoracic Doppler 2D Echocardiography

A type of echocardiography performed using sound waves to create images of the heart from outside the chest.

Signup and view all the flashcards

Blood tests for Heart failure

Blood tests that are part of a comprehensive assessment for heart failure.

Signup and view all the flashcards

High Natriuretic Peptides

High levels of natriuretic peptides (BNP or NTproBNP) in the blood can suggest a higher risk of heart failure or poor prognosis.

Signup and view all the flashcards

ACE Inhibitors

A type of medicine that helps to lower blood pressure and improve blood flow, often used for heart failure.

Signup and view all the flashcards

Beta-Blockers

A type of medication that helps to improve blood flow, often used to treat heart failure.

Signup and view all the flashcards

Diuretics

A type of medicine that helps to reduce fluid retention, often used to treat heart failure.

Signup and view all the flashcards

Calcium Channel Blockers

A type of medicine that helps to lower blood pressure, often used to treat heart failure.

Signup and view all the flashcards

Anticoagulants

A type of medicine that helps to thin the blood and prevent blood clots, often used in patients with heart failure.

Signup and view all the flashcards

Aspirin

A type of medicine that helps to reduce the risk of heart attack or stroke, often used in patients with heart failure.

Signup and view all the flashcards

Inotropic Agents

Medications that help to strengthen the heart's contractions, often used to treat severe heart failure.

Signup and view all the flashcards

Amiodarone

A type of medicine that helps to control abnormal heart rhythms, often used to treat heart failure.

Signup and view all the flashcards

Ejection Fraction

The fraction of blood that is pumped out of the left ventricle with each heartbeat.

Signup and view all the flashcards

Symptom Class

A category that describes the severity of symptoms and limitations in physical activity in patients with heart failure.

Signup and view all the flashcards

Cardiomyopathy

A condition of the heart muscle that makes it difficult for the heart to pump blood efficiently.

Signup and view all the flashcards

Diastolic Heart Failure

A type of heart failure due to the heart's ability to relax and fill with blood properly.

Signup and view all the flashcards

Systolic Heart Failure

A type of heart failure due to the heart's ability to contract and pump blood efficiently.

Signup and view all the flashcards

Hypertrophic Cardiomyopathy

A condition where the heart muscle is thickened and the heart chambers are smaller, which can lead to heart failure.

Signup and view all the flashcards

Aortic Stenosis

A narrowing of the aortic valve, which can lead to heart failure.

Signup and view all the flashcards

Right Ventricular Failure

A type of heart failure due to the heart's inability to pump blood efficiently, leading to a buildup of pressure in the blood vessels.

Signup and view all the flashcards

ARB

A type of medicine that helps to lower blood pressure, often used to treat heart failure.

Signup and view all the flashcards

Aldosterone Antagonist

A type of medicine that helps to reduce the body's production of aldosterone, a hormone that can cause fluid and salt retention, often used to treat heart failure.

Signup and view all the flashcards

Coronary Artery Disease

A narrowing of the coronary arteries, which can lead to heart attacks.

Signup and view all the flashcards

Dilated Cardiomyopathy

A condition where the heart muscle is weakened and enlarged, which can lead to heart failure.

Signup and view all the flashcards

Edema

A buildup of fluid in the body, often caused by heart failure.

Signup and view all the flashcards

Study Notes

Investigations

  • Take a history, perform a clinical examination and undertake standard investigations to rule out other causes.
  • ECG (Signs of MI, dysrhythmias)
  • Chest X-ray (look for cardiomegaly, signs of pulmonary oedema)
  • Blood tests (electrolytes, urea and creatinine, eGFR, thyroid function tests, fasting lipids, fasting glucose, full blood count)
  • Urinalysis
  • Arterial blood gases
  • Peak flow or spirometry

Measurement of serum natriuretic peptide levels

  • In people presenting with new suspected acute heart failure, use a single measurement of serum natriuretic peptides (B-type natriuretic peptide or N-terminal pro-B-type natriuretic peptide) and the following thresholds to rule out the diagnosis of heart failure:
    • B-type natriuretic peptide less than 100 ng/litre
    • N-terminal pro-B-type natriuretic peptide less than 300 ng/litre.

Echocardiography

  • In people presenting with new suspected acute heart failure with raised natriuretic peptide levels, perform transthoracic Doppler 2D echocardiography to establish the presence or absence of cardiac abnormalities.

  • In people presenting with new suspected acute heart failure, consider performing transthoracic Doppler 2D echocardiography within 48 hours of admission to guide early specialist management.

  • Do not routinely offer pulmonary artery catheterisation to people with acute heart failure.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

More Like This

Use Quizgecko on...
Browser
Open
Browser
Browser