Podcast
Questions and Answers
What is the typical ejection fraction in patients with systolic heart failure with reduced ejection fraction (HFrEF)?
What is the typical ejection fraction in patients with systolic heart failure with reduced ejection fraction (HFrEF)?
- Less than or equal to 40% (correct)
- Between 50% and 60%
- Greater than or equal to 50%
- Approximately 65%
Which of the following best describes the primary problem in diastolic heart failure (HFpEF)?
Which of the following best describes the primary problem in diastolic heart failure (HFpEF)?
- Severe valve regurgitation
- Stiff heart with impaired relaxation and filling (correct)
- Excessive fluid volume overload
- Impaired ventricular contraction
Which of the following is a common cause of systolic heart failure (HFrEF)?
Which of the following is a common cause of systolic heart failure (HFrEF)?
- Hypertension
- Aging
- Hypertrophic cardiomyopathy
- Ischemia or myocardial infarction (correct)
What is the main pathophysiological mechanism in systolic heart failure (HFrEF)?
What is the main pathophysiological mechanism in systolic heart failure (HFrEF)?
Which of the following is a typical therapeutic approach for systolic heart failure (HFrEF)?
Which of the following is a typical therapeutic approach for systolic heart failure (HFrEF)?
What is a primary pathophysiological characteristic of right-sided heart failure (RHF)?
What is a primary pathophysiological characteristic of right-sided heart failure (RHF)?
Which condition is most likely to directly cause pulmonary disease (cor pulmonale)?
Which condition is most likely to directly cause pulmonary disease (cor pulmonale)?
What is the primary cause of pulmonary congestion and edema in left-sided heart failure (LHF)?
What is the primary cause of pulmonary congestion and edema in left-sided heart failure (LHF)?
Which of the following is a common clinical manifestation of right-sided heart failure (RHF)?
Which of the following is a common clinical manifestation of right-sided heart failure (RHF)?
What is a typical compensatory mechanism activated in systolic heart failure (HFrEF)?
What is a typical compensatory mechanism activated in systolic heart failure (HFrEF)?
Which of the following best explains the clinical presentation of peripheral edema in right-sided heart failure (RHF)?
Which of the following best explains the clinical presentation of peripheral edema in right-sided heart failure (RHF)?
Which of the following is the least likely cause of diastolic heart failure (HFpEF)?
Which of the following is the least likely cause of diastolic heart failure (HFpEF)?
A patient presents with dyspnea, pulmonary crackles, and an S3 heart sound. Which type of heart failure is most likely?
A patient presents with dyspnea, pulmonary crackles, and an S3 heart sound. Which type of heart failure is most likely?
What is the most direct consequence of reduced cardiac output in left-sided heart failure (LHF)?
What is the most direct consequence of reduced cardiac output in left-sided heart failure (LHF)?
In the context of heart failure, what is the significance of increased afterload on a patient's condition?
In the context of heart failure, what is the significance of increased afterload on a patient's condition?
Which serum biomarker is most useful in differentiating between cardiac and pulmonary causes of acute dyspnea?
Which serum biomarker is most useful in differentiating between cardiac and pulmonary causes of acute dyspnea?
Which statement accurately contrasts systolic and diastolic heart failure regarding the heart's structure?
Which statement accurately contrasts systolic and diastolic heart failure regarding the heart's structure?
A patient with known heart failure presents with increasing dyspnea. Initial investigations reveal elevated jugular venous pressure (JVP) and peripheral edema, but normal lung sounds. Which of the following interventions would MOST directly address the primary underlying pathophysiology?
A patient with known heart failure presents with increasing dyspnea. Initial investigations reveal elevated jugular venous pressure (JVP) and peripheral edema, but normal lung sounds. Which of the following interventions would MOST directly address the primary underlying pathophysiology?
A researcher is investigating new potential drug targets for heart failure with preserved ejection fraction (HFpEF). Based on the known pathophysiology of HFpEF, which of the following molecular mechanisms would be the MOST promising target?
A researcher is investigating new potential drug targets for heart failure with preserved ejection fraction (HFpEF). Based on the known pathophysiology of HFpEF, which of the following molecular mechanisms would be the MOST promising target?
A patient with systolic heart failure (HFrEF) is being managed with optimal doses of an ACE inhibitor, beta-blocker, and diuretic. Despite this, he continues to have persistent symptoms of dyspnea and fatigue. What additional medication should be considered?
A patient with systolic heart failure (HFrEF) is being managed with optimal doses of an ACE inhibitor, beta-blocker, and diuretic. Despite this, he continues to have persistent symptoms of dyspnea and fatigue. What additional medication should be considered?
Flashcards
Systolic Heart Failure (HFrEF)
Systolic Heart Failure (HFrEF)
Heart failure with reduced ejection fraction (≤40%), impaired contraction.
Diastolic Heart Failure (HFpEF)
Diastolic Heart Failure (HFpEF)
Heart failure with preserved ejection fraction (≥50%), impaired relaxation/filling.
Common Causes of Systolic HF
Common Causes of Systolic HF
Ischemia, MI, dilated cardiomyopathy, or volume overload.
Common Causes of Diastolic HF
Common Causes of Diastolic HF
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Pathophysiology of Systolic HF
Pathophysiology of Systolic HF
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Pathophysiology of Diastolic HF
Pathophysiology of Diastolic HF
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Response to Therapy for Systolic HF
Response to Therapy for Systolic HF
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Response to Therapy for Diastolic HF
Response to Therapy for Diastolic HF
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Left-Sided Heart Failure (LHF)
Left-Sided Heart Failure (LHF)
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Right-Sided Heart Failure (RHF)
Right-Sided Heart Failure (RHF)
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Results of Left-Sided Heart Failure
Results of Left-Sided Heart Failure
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Causes of LHF
Causes of LHF
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Causes of RHF
Causes of RHF
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Manifestations of LHF
Manifestations of LHF
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Manifestations of RHF
Manifestations of RHF
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Study Notes
- Visual Study Guide: Systolic vs. Diastolic Heart Failure
Systolic Heart Failure (HFrEF)
- Ejection Fraction (EF) is reduced (≤ 40%)
- Primary Problem: Weak heart with impaired contraction
- Common Causes: Ischemia, MI, dilated cardiomyopathy with volume overload
- Pathophysiology: Decreased contractility leads to decreased cardiac output
- Pulmonary Congestion is common
- Peripheral Edema is common, especially if RHF develops
- Good response to ACE inhibitors and beta-blockers
Diastolic Heart Failure (HFpEF)
- Ejection Fraction (EF) is preserved (≥ 50%)
- Primary Problem: Stiff heart with impaired relaxation/filling
- Common Causes: Hypertension, aging, hypertrophic or restrictive cardiomyopathy
- Pathophysiology: Increased LV filling pressure leads to pulmonary congestion
- Pulmonary Congestion is common
- Peripheral Edema may occur
- Limited options for therapy: manage BP, heart rate, and comorbidities
Left-Sided Heart Failure (LHF) Pathophysiology
- Inadequate left ventricular function causes blood to back up into the left atrium and pulmonary circulation
- Causes include hypertension, ischemic heart disease/MI, cardiomyopathy, and aortic or mitral valve disease
- Results in pulmonary congestion and edema, as well as decreased cardiac output leading to fatigue and poor tissue perfusion
- Clinical manifestations: Dyspnea, especially on exertion, orthopnea, paroxysmal nocturnal dyspnea, pulmonary crackles, fatigue, weakness, possible S3 heart sound
Right-Sided Heart Failure (RHF) Pathophysiology
- Ineffective pumping of the right ventricle causes blood to back up into systemic venous circulation
- Commonly caused by left-sided heart failure, pulmonary disease (cor pulmonale), and tricuspid or pulmonary valve disease
- Clinical manifestations: Peripheral edema (legs, ankles, feet), jugular venous distention (JVD), hepatosplenomegaly, ascites, weight gain (due to fluid retention), and fatigue
Systolic HF (HFrEF) versus Diastolic HF (HFpEF)
- Systolic: Reduced ejection fraction (≤ 40%); Diastolic: Preserved ejection fraction (≥ 50%)
- Systolic: "Weak heart" with impaired contraction; Diastolic: "Stiff heart" with impaired filling
- Systolic: Ischemia/MI, dilated cardiomyopathy, chronic volume overload; Diastolic: Hypertension, aging, hypertrophic or restrictive cardiomyopathy
- Systolic: Damaged myocytes lead to decreased contractility and cardiac output; Diastolic: Ventricles can't relax, high LV filling pressure backs blood into lungs
- Systolic: RAAS & SNS activation, remodeling & hypertrophy; Diastolic: Increased afterload & HR worsen filling time
- Pulmonary congestion is common in both
- Peripheral edema: common (if RHF develops) in Systolic, may occur in Diastolic
- Response to Therapy: Systolic has better evidence for medications (ACE inhibitors, beta-blockers, etc.); Diastolic has less evidence-based therapy, focus on managing BP and comorbidities
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