Chapter 6. Heart Failure
Which of the following findings, when increased, indicates elevated cardiac filling pressures (or volume overload) in a patient with heart failure?
Option A: Incorrect. LVH is a marker of hypertrophy, but is not specific to volume status.
Option B: Incorrect. Potassium level is not indicative of volume.
Option C: Incorrect. LVEF provides information about the heart's contractile function after completion of diastole.
Option D: Correct. B-type natriuretic peptide is released by the ventricles in response to chamber wall stretch and increased filling pressures that accompany volume retention.
What is the most common etiology of heart failure?
B. Idiopathic, unknown cause
Option A: Correct. Ischemic etiology, resulting from coronary artery disease, is the most common cause of HFrEF, occurring in up to 2/3 of cases.
Option B: Incorrect. Idiopathic cardiomyopathy, while common, is not as frequent as ischemic etiology.
Options C and D: Incorrect. Viral and drug induced cardiomyopathy are rare causes of heart failure.
What is the medical term for the symptom of "patient awakens with a feeling of breathlessness not relieved by sitting up"?
C. Paroxysmal nocturnal dyspnea
Option A: Incorrect. Orthopnea refers to shortness of breath with a recumbent position that subsides when sitting up.
Option B: Incorrect. Hepatojugular reflex refers to eliciting jugular venous distension upon pressing on the liver.
Option C: Correct. PND does not typically subside with sitting up.
Option D: Incorrect. Pulmonary congestion is a general term referring to excess volume in the lungs.
Which of the following is true regarding ACE inhibitors in heart failure?
A. May cause hypotension and hypokalemia
B. Should be avoided in the setting of mild renal dysfunction