Which explanation of systolic heart failure demonstrates an understanding of the
condition?
“The ventricle loses compliance over time, so it requires more pressure to perform work.”
The ventricle becomes less compliant over time in diastolic heart failure. More pressure is
needed to move the same amount of volume compared with a healthy heart.
“Systolic HF happens when the heart cannot squeeze hard enough to pump blood efficiently.”
Correct answer
Systolic heart failure results when the heart cannot contract forcefully enough to eject adequate
amounts of blood into circulation.
“Preload increases with increased muscle contractility.”
Preload increases with decreased contractility.
“Cardiac output is increased, overwhelming the peripheral vascular system.”
In systolic failure, cardiac output is decreased, and fluid backs up into the pulmonary system.
“The heart has trouble relaxing, so the ventricle cannot fill properly.”
Inadequate relaxation or “stiffening” prevents the ventricle from filling with sufficient blood for
adequate cardiac output in diastolic heart failure.
“Systolic heart failure may manifest in pulmonary and systemic congestion.”
Correct answer
Manifestations of systolic dysfunction may include symptoms of inadequate tissue perfusion and
pulmonary and systemic congestion.
Confidence level:
Not Sure
Lesson:Heart Failure
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Which mechanism does the body use to compensate for heart failure?
Hypertrophy of the myocardium
Correct answer
When cardiac output fails to meet the demands of the body, compensatory mechanisms work to
improve output. Myocardial hypertrophy is one of the major compensatory mechanisms as the
heart works harder to pump blood.
Renin-angiotensin system (RAS) activation
Correct answer
Activation of the (RAS) leads to vasoconstriction in an effort to maintain blood pressure.
Inflammation of the myocardium
Inflammation of the myocardium is not one of the compensatory mechanisms. Hypertrophy of
the myocardium is a compensatory mechanism.
Decreased blood pressure
Decreased blood pressure is not one of the major compensatory mechanisms. A drop in blood
pressure is likely to trigger mechanisms such as the RAS system to preserve cardiac output.
Stimulation of the sympathetic nervous system
Correct answer
In heart failure (HF), stimulation of the sympathetic nervous system (i.e., increasing
catecholamines) as a result of tissue hypoxia, represents the most immediate compensatory
mechanism.
Confidence level:
Confident
, Lesson:Heart Failure
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Which pathology is a common cause of heart failure?
Cancer
Cancer is not a common cause of heart failure. Hypertension and structural changes are frequent
causes.
Hypertension
Correct answer
Heart failure is caused by systemic hypertension in most cases. Other common causes include
myocardial infarction (MI) and structural heart changes.
Liver congestion
Liver congestion is a symptom of right-sided heart failure, not a cause. It is a sign related to
impaired liver function.
Low ejection fraction (EF)
Reduced EF is a symptom of heart failure that results from the inability of the heart to contract
forcefully enough to eject adequate amounts of blood into circulation.
Confidence level:
Confident
Lesson:Heart Failure
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Which sign or symptom is related to right-sided heart failure?
Coughing
As the ejection fraction decreases in left-sided heart failure, hydrostatic pressure builds in the
pulmonary venous system, causing fluid-filled alveoli, pulmonary congestion, and coughing.
Cyanosis
In left ventricular systolic dysfunction, cardiac output (CO) is diminished, leading to impaired
tissue perfusion, anaerobic metabolism, and unusual fatigue. Cyanosis is a classic sign of
impaired tissue perfusion.
Dyspnea
In left-sided heart failure, increasing pulmonary venous pressure and pulmonary congestion
causes dyspnea. The patient may describe “trouble catching my breath,” “breathlessness,” or
“difficulty breathing.”
Edema
Correct answer
Signs of systemic congestion occur as the right ventricle fails. Fluid is retained. Pressure builds
in the venous system. Edema develops in the lower legs. Edema may progress to the thighs and
abdominal wall.
Confidence level:
Confident
Lesson:Heart Failure
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Which finding is associated with right-sided heart failure?
Pulsus alternans
In left-sided heart failure, the pulse may be tachycardic, or it may alternate in strength, known as
pulsus alternans.
condition?
“The ventricle loses compliance over time, so it requires more pressure to perform work.”
The ventricle becomes less compliant over time in diastolic heart failure. More pressure is
needed to move the same amount of volume compared with a healthy heart.
“Systolic HF happens when the heart cannot squeeze hard enough to pump blood efficiently.”
Correct answer
Systolic heart failure results when the heart cannot contract forcefully enough to eject adequate
amounts of blood into circulation.
“Preload increases with increased muscle contractility.”
Preload increases with decreased contractility.
“Cardiac output is increased, overwhelming the peripheral vascular system.”
In systolic failure, cardiac output is decreased, and fluid backs up into the pulmonary system.
“The heart has trouble relaxing, so the ventricle cannot fill properly.”
Inadequate relaxation or “stiffening” prevents the ventricle from filling with sufficient blood for
adequate cardiac output in diastolic heart failure.
“Systolic heart failure may manifest in pulmonary and systemic congestion.”
Correct answer
Manifestations of systolic dysfunction may include symptoms of inadequate tissue perfusion and
pulmonary and systemic congestion.
Confidence level:
Not Sure
Lesson:Heart Failure
Writing IconReport content error
Which mechanism does the body use to compensate for heart failure?
Hypertrophy of the myocardium
Correct answer
When cardiac output fails to meet the demands of the body, compensatory mechanisms work to
improve output. Myocardial hypertrophy is one of the major compensatory mechanisms as the
heart works harder to pump blood.
Renin-angiotensin system (RAS) activation
Correct answer
Activation of the (RAS) leads to vasoconstriction in an effort to maintain blood pressure.
Inflammation of the myocardium
Inflammation of the myocardium is not one of the compensatory mechanisms. Hypertrophy of
the myocardium is a compensatory mechanism.
Decreased blood pressure
Decreased blood pressure is not one of the major compensatory mechanisms. A drop in blood
pressure is likely to trigger mechanisms such as the RAS system to preserve cardiac output.
Stimulation of the sympathetic nervous system
Correct answer
In heart failure (HF), stimulation of the sympathetic nervous system (i.e., increasing
catecholamines) as a result of tissue hypoxia, represents the most immediate compensatory
mechanism.
Confidence level:
Confident
, Lesson:Heart Failure
Writing IconReport content error
Which pathology is a common cause of heart failure?
Cancer
Cancer is not a common cause of heart failure. Hypertension and structural changes are frequent
causes.
Hypertension
Correct answer
Heart failure is caused by systemic hypertension in most cases. Other common causes include
myocardial infarction (MI) and structural heart changes.
Liver congestion
Liver congestion is a symptom of right-sided heart failure, not a cause. It is a sign related to
impaired liver function.
Low ejection fraction (EF)
Reduced EF is a symptom of heart failure that results from the inability of the heart to contract
forcefully enough to eject adequate amounts of blood into circulation.
Confidence level:
Confident
Lesson:Heart Failure
Writing IconReport content error
Which sign or symptom is related to right-sided heart failure?
Coughing
As the ejection fraction decreases in left-sided heart failure, hydrostatic pressure builds in the
pulmonary venous system, causing fluid-filled alveoli, pulmonary congestion, and coughing.
Cyanosis
In left ventricular systolic dysfunction, cardiac output (CO) is diminished, leading to impaired
tissue perfusion, anaerobic metabolism, and unusual fatigue. Cyanosis is a classic sign of
impaired tissue perfusion.
Dyspnea
In left-sided heart failure, increasing pulmonary venous pressure and pulmonary congestion
causes dyspnea. The patient may describe “trouble catching my breath,” “breathlessness,” or
“difficulty breathing.”
Edema
Correct answer
Signs of systemic congestion occur as the right ventricle fails. Fluid is retained. Pressure builds
in the venous system. Edema develops in the lower legs. Edema may progress to the thighs and
abdominal wall.
Confidence level:
Confident
Lesson:Heart Failure
Writing IconReport content error
Which finding is associated with right-sided heart failure?
Pulsus alternans
In left-sided heart failure, the pulse may be tachycardic, or it may alternate in strength, known as
pulsus alternans.
