Heart Failure

Question 1

What are the 2 types of Chronic HF?

Answer 1

1. Systolic HF

2. Diastolic HF

Question 2

What is the cause of Systolic HF?

Answer 2

Impaired left ventricular contraction

Question 3

What is the cause of Diastolic HF?

Answer 3

Left Ventricular Relaxation

Question 4

What are the causes of HF? (4 things)

Answer 4

1. Ischaemic Heart Disease
2. Valvular Heart Disease (commonly aortic stenosis)
3. Hypertension
4. Arrhythmias (commonly atrial fibrillation)

Question 5

What is the most common cause of HF in the UK?

Answer 5

Coronary Artery Disease (part of IHD)

Question 6

What are the clinical features of HF? (5 things)

Answer 6

1. SOB (worse on exertion)
2. Cough (maybe frothy white / pink sputum)
3. Orthopnoea (SOB @ lying flat) (use beh pillows)
4. Paroxysmal Nocturnal Dyspnoea
5. Peripheral oedema

Question 7

What is the diagnosis of HF based on? (4 things)

Answer 7

1. Clinical presentation
2. BNP blood test (specifically “N-terminal pro-B-type natriuretic peptide” – NT proBNP)
3. Echocardiogram
4. ECG

Question 8

What is the NICE guideline management options for HF? (5 things)

Answer 8

1. Refer to specialist
2. Discussion + Explanation of condition
3. Medical management
4. Surgical management (if severe Aortic Stenosis / Mitral Regurg.)
5. HF specialist nurse for advice + support

Question 9

What are the first line Medical Management options for HF? (4 things)

Answer 9

1. ACE inhibitor (e.g. Ramipril)
2. Beta blocker (e.g. Bisoprolol)
3. Spironolactone (Aldosterone antagonoist) (if reduced EF and A+B not controlling symptoms)
4. Loop diuretics (e.g. Furosemide)

ABS

Question 10

Which HF patients should you not give ACE inhibitors to?

Answer 10

Valvular heart disease

Question 11

What should be given to HF patients if they can’t have ACE inhibitors?

Answer 11

Angiotensin Receptor Blockers (ARBs) (e.g. Candesartan)

Question 12

What should HF patients on diuretics / ACE inhibitors / aldosterone antagonists be monitored for?

Answer 12

U&Es because meds can cause electrolyte disturbance