Heart Failure

Question 1

• Epi: Prevalence? Incidence? Mortality? Cost? How many die within 5 years?
• Definition?
• Systolic dysfunction? Decreased? Due to? Causes? (6)
• Diastolic dysfunction? EF? Due to? Causes? (5)
• Compensation for lowered CO? (3)
• NY Functional class scoring?
• AHA HF stages?
• HF precipitating factors? (6)
• Clinical course of HF?

Answer 1

• 5 million; 5k; 250k; 40 billion; 1/2
• Syndrome; Inability to pump enough blood forward or can only do so if cardiac filling pressures are abnormally high
• Problem with squeeze; decreased contraction; MI, alcohol, meth, mitral regurg
• Problem with relaxation; normal; problem filling; Htx, Aortic stenosis, dialyisis, fibrosis
• Neurohormonal = RAAS, baro receptor; increased preload; ventricular remodeling

Question 2

• NY Functional class scoring?
• AHA HF stages?
• HF precipitating factors? (6)
• Clinical course of HF?

Answer 2

• Asymptomatic, symtoms with exertion, symptoms with minimal, symptoms at rest
• No symp but at risk; structural HD but no symptoms, structural HD with prior/ current symptoms; Intervention needed
• Increased preload, afterload, dec ino; arrythmic rate, higher metabolic demands, med adherence
• non linear