HF - PHARM EXAM 2| TOP SCORES MADE SIMPLE |
TRUSTED TEST SOLUTIONS!
heart failure (HF) definition, sx Answer: structural or functional impairment of ventricular
filling or ejection of blood
SOB, fatigue, edema, splanchnic congestion, exercise intolerance,
HFrEF Answer: HF with reduced EF
LVEF </=40%
HFimpEF Answer: HF with improved EF
previous LVEF </=40% and a f/u measurement of LVEF >40%
HFmrEF Answer: HF with mildly reduced EF
LVEF 41%-49%
may see evidence of spontaneous or provokable increased LV filling pressures
HFpEF Answer: HF with preserved EF
LVEF >/= 50%
may see evidence of spontaneous or provokable increased LV filling pressures
common causes of HF Answer: CAD, HTN, valve dysfunction, genetic, alcohol, drug
induced (non-DHP CCBs, anti-TNF, beta blockers)
HF - neurohormonal model Answer: Short term solutions to the heart's current problem
cause long term issues and damage
An initial damage to the myocardium causes a decrease in cardiac output
To increase cardiac output, the body releases multiple neurohormones (renin,
aldosterone, epi, norepi) and these will stimulate the heart to change
The heart can become stiff due to an increase in the size of the heart wall or flabby and
weak with thin heart walls
systolic dysfunction vs diastolic dysfunction Answer: systolic dysfunction - heart can fill,
trouble with ejecting
diastolic dysfunction - heart has less blood filling ventricles, ventricles can eject a larger
% of blood that's filled, but the over all volume of blood leaving the heart is less
1
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, algorithm for pts with suspected HF Answer: Hx, PE, labs (BNP), ECG, echo
if HF confirmed determine if HFrEF (LVEF <40%), HFmrEF (LVEF41-49%), or HFpEF
(LVEF>50)
treat
HF Diagnosis can be guided by Answer: signs/symptoms
CXR
BNP
pulmonary capillary wedge pressure
RV dysfunction vs LV dysfunction Answer: RV dysfunction Sx:
abd pain, constipation, anorexia, weakness/fatigue
RV dysfunction signs:
ascites, hepatomegaly, edema, JVD
LV dysfunction sx: cough, DOE, tachypnea, pillow orthopnea
LV dysfunction signs: pulmonary edema, Cheyne stokes respirations
goals of HF treatment Answer: reduce morbidity and mortality
reduce sx and improve QOL
reduce hospitalizations and decompensation
how to classify HF Answer: pt symptoms
the heart
HF - NYHA classification Answer: can classify HF by patient sx. ranges from I-IV
I (mild) - no limitation of physical activity (no sx with physical activity)
II (mild) - slight limitation of physical activity (some sx with physical activity, comfy at
rest)
III (moderate) - marked limitation of physcial activity (sx with ordinary activiity, comfy at
rest)
IV (severe) - unable to carry out any physical activity without discomfort (sx at rest,
worse with exertion)
stages of HF Answer: stage A - at risk for HF
2
APPHIA - Crafted with Care and Precision for Academic Excellence.
TRUSTED TEST SOLUTIONS!
heart failure (HF) definition, sx Answer: structural or functional impairment of ventricular
filling or ejection of blood
SOB, fatigue, edema, splanchnic congestion, exercise intolerance,
HFrEF Answer: HF with reduced EF
LVEF </=40%
HFimpEF Answer: HF with improved EF
previous LVEF </=40% and a f/u measurement of LVEF >40%
HFmrEF Answer: HF with mildly reduced EF
LVEF 41%-49%
may see evidence of spontaneous or provokable increased LV filling pressures
HFpEF Answer: HF with preserved EF
LVEF >/= 50%
may see evidence of spontaneous or provokable increased LV filling pressures
common causes of HF Answer: CAD, HTN, valve dysfunction, genetic, alcohol, drug
induced (non-DHP CCBs, anti-TNF, beta blockers)
HF - neurohormonal model Answer: Short term solutions to the heart's current problem
cause long term issues and damage
An initial damage to the myocardium causes a decrease in cardiac output
To increase cardiac output, the body releases multiple neurohormones (renin,
aldosterone, epi, norepi) and these will stimulate the heart to change
The heart can become stiff due to an increase in the size of the heart wall or flabby and
weak with thin heart walls
systolic dysfunction vs diastolic dysfunction Answer: systolic dysfunction - heart can fill,
trouble with ejecting
diastolic dysfunction - heart has less blood filling ventricles, ventricles can eject a larger
% of blood that's filled, but the over all volume of blood leaving the heart is less
1
APPHIA - Crafted with Care and Precision for Academic Excellence.
, algorithm for pts with suspected HF Answer: Hx, PE, labs (BNP), ECG, echo
if HF confirmed determine if HFrEF (LVEF <40%), HFmrEF (LVEF41-49%), or HFpEF
(LVEF>50)
treat
HF Diagnosis can be guided by Answer: signs/symptoms
CXR
BNP
pulmonary capillary wedge pressure
RV dysfunction vs LV dysfunction Answer: RV dysfunction Sx:
abd pain, constipation, anorexia, weakness/fatigue
RV dysfunction signs:
ascites, hepatomegaly, edema, JVD
LV dysfunction sx: cough, DOE, tachypnea, pillow orthopnea
LV dysfunction signs: pulmonary edema, Cheyne stokes respirations
goals of HF treatment Answer: reduce morbidity and mortality
reduce sx and improve QOL
reduce hospitalizations and decompensation
how to classify HF Answer: pt symptoms
the heart
HF - NYHA classification Answer: can classify HF by patient sx. ranges from I-IV
I (mild) - no limitation of physical activity (no sx with physical activity)
II (mild) - slight limitation of physical activity (some sx with physical activity, comfy at
rest)
III (moderate) - marked limitation of physcial activity (sx with ordinary activiity, comfy at
rest)
IV (severe) - unable to carry out any physical activity without discomfort (sx at rest,
worse with exertion)
stages of HF Answer: stage A - at risk for HF
2
APPHIA - Crafted with Care and Precision for Academic Excellence.
