CVRN Heart Failure, Hypertension, Cardiomyopathy
questions with correct answers
Heart Failure with Preserved Ejection Fraction (HFpEF) Correct
Answer-Is a new term for diastolic dysfunction
Several criteria define the syndrome of HFpEF:
- Clinical signs / symptoms of HF
- Preserved LVEF
- Abnormal LV diastolic dysfunction
Hypertension remains the most important cause of HFpEF
Heart Failure with Reduced Ejection Fraction (HFrEF) Correct Answer-
Is a new term for systolic dysfunction
HFrEF is defined as the clinical diagnosis of HF and EF ≤40%
What are the most common causes of Heart Failure (HF)? Correct
Answer-- 2/3 of patients with systolic dysfunction have coronary artery
disease (CAD)
- Hypertension is a common cause in diastolic dysfunction
- Arrhythmias, with atrial fibrillation as the most common
Heart Failure Pathophysiology Correct Answer-There is impaired
forward flow from the left ventricle (LV) due to decreased contractility
- Impaired contractility (low EF) causes compensatory increases in HR
and preload
- Compensatory mechanisms over time may lead to dilation of the LV
,- Left Atria (LA)and pulmonary venous pressures rise producing
pulmonary congestion (pulmonary edema)
Hemodynamic Changes in HFpEF (Diastolic Dysfunction) Correct
Answer-LV has abnormal diastolic relaxation or filling and a normal EF
which leads to an increase in LV diastolic, LA and pulmonary venous
pressures
- Caused by LV that is stiff and non-compliant due to hypertrophy,
ischemia, scarring or infiltrative disease
- Increased HR not tolerated well due to decreased diastolic filling time
- Atrial fibrillation not tolerated due to loss of atrial contraction leading
to decreased LV filling
Heart Failure: Physical Assessment Correct Answer-- Vital signs: HR,
pulse pressure
- Pulmonary congestion (crackles/rales, pleural effusions)
- Peripheral Edema, ascites, hepatomegaly
- Elevated Jugular venous pressure
- Heart Sounds: presence of S3
What are the causes of right-sided HF? Correct Answer-- Pulmonary
disease
Pulmonary hypertension
Pulmonary emboli
COPD
, - LV failure
- RV infarct
What are the symptoms of right-sided HF? Correct Answer-- Peripheral
edema
- Elevated JVP
- Hepatomegaly etc
What is the definition of cor pulmonale? Correct Answer-- An alteration
in the structure and function of the RV caused by a primary disorder of
the respiratory system (Sovari, 2014)
- Slow and chronic development, or can be acute
- RV failure due to LV failure is NOT considered cor pulmonale
What is the pathophysiology of cor pulmonale? Correct Answer-
Elevated pulmonary pressures (pulmonary hypertension) lead to right-
sided heart strain and failure
What are the common causes of cor pulmonale? Correct Answer--
COPD
- ILD (Interstitial lung disease)
- Pulmonary hypertension
- Obstructive sleep apnea
- Pulmonary emboli
questions with correct answers
Heart Failure with Preserved Ejection Fraction (HFpEF) Correct
Answer-Is a new term for diastolic dysfunction
Several criteria define the syndrome of HFpEF:
- Clinical signs / symptoms of HF
- Preserved LVEF
- Abnormal LV diastolic dysfunction
Hypertension remains the most important cause of HFpEF
Heart Failure with Reduced Ejection Fraction (HFrEF) Correct Answer-
Is a new term for systolic dysfunction
HFrEF is defined as the clinical diagnosis of HF and EF ≤40%
What are the most common causes of Heart Failure (HF)? Correct
Answer-- 2/3 of patients with systolic dysfunction have coronary artery
disease (CAD)
- Hypertension is a common cause in diastolic dysfunction
- Arrhythmias, with atrial fibrillation as the most common
Heart Failure Pathophysiology Correct Answer-There is impaired
forward flow from the left ventricle (LV) due to decreased contractility
- Impaired contractility (low EF) causes compensatory increases in HR
and preload
- Compensatory mechanisms over time may lead to dilation of the LV
,- Left Atria (LA)and pulmonary venous pressures rise producing
pulmonary congestion (pulmonary edema)
Hemodynamic Changes in HFpEF (Diastolic Dysfunction) Correct
Answer-LV has abnormal diastolic relaxation or filling and a normal EF
which leads to an increase in LV diastolic, LA and pulmonary venous
pressures
- Caused by LV that is stiff and non-compliant due to hypertrophy,
ischemia, scarring or infiltrative disease
- Increased HR not tolerated well due to decreased diastolic filling time
- Atrial fibrillation not tolerated due to loss of atrial contraction leading
to decreased LV filling
Heart Failure: Physical Assessment Correct Answer-- Vital signs: HR,
pulse pressure
- Pulmonary congestion (crackles/rales, pleural effusions)
- Peripheral Edema, ascites, hepatomegaly
- Elevated Jugular venous pressure
- Heart Sounds: presence of S3
What are the causes of right-sided HF? Correct Answer-- Pulmonary
disease
Pulmonary hypertension
Pulmonary emboli
COPD
, - LV failure
- RV infarct
What are the symptoms of right-sided HF? Correct Answer-- Peripheral
edema
- Elevated JVP
- Hepatomegaly etc
What is the definition of cor pulmonale? Correct Answer-- An alteration
in the structure and function of the RV caused by a primary disorder of
the respiratory system (Sovari, 2014)
- Slow and chronic development, or can be acute
- RV failure due to LV failure is NOT considered cor pulmonale
What is the pathophysiology of cor pulmonale? Correct Answer-
Elevated pulmonary pressures (pulmonary hypertension) lead to right-
sided heart strain and failure
What are the common causes of cor pulmonale? Correct Answer--
COPD
- ILD (Interstitial lung disease)
- Pulmonary hypertension
- Obstructive sleep apnea
- Pulmonary emboli
