Heart Failure

Question 1

HF signs and symptoms

Answer 1

Sy: congestion, dyspnea, orthopnea, fatigue
Si: S3, Rale, Jugular vein distention, pitting edema

Systolic dysfunction: ⬇️Ef, ⬆️EDV, ⬇️contractility sue to MI or dilated CMP

Diastolic dysfunction: preserved EF, normal EDV, ⬇️compliance, ⬆️EDP due to myocardial hypertrophy

Question 2

Hf tx

Answer 2

⬇️mortality:
ACEI
Beta blocker (except in acute decompensated)
Spironolacton

Symptom relieve: thiazide / loop diuretic

Both symptom and mortality: hydralazine with nitrate

Question 3

Cor pulmonale

Answer 3

Isolated Rt HF due to pulmonary cause

Question 4

Lt HF

Answer 4

• Orthopnea (supine): ⬆️venous return from redistribution of blood (immediately standing) exacerbates pulmonary vascular congestion
• PND: redistribution and reabsorption of pulmonary edema
• PE: presence of HF cells or hemosiderin-laden macrophages in lung, pulmonary venous pressure ⬆️: distention and transudation

Question 5

Rt HF

Answer 5

• Hepatomegaly: ⬆️ CVP: ⬆️ portal resistance : cardiac cirrhosis or nutmeg liver
• JV distention: ⬆️venous pressure
• Peripheral Edema: same