Chapter 2 BNF (Heart Failure)

Question 1

Heart Failure symptoms?

Answer 1

Dyspnoea (SOB)
Exercise intolerance
Oedema (Pulmonary and peripheral

Question 2

First line in Heart Failure?

Answer 2

ACEi/ARB + Beta Blocker

ARB - Candersartan, Valsartan

ACE - Nebivolol, Bisoprolol, Carvedilol

Alternative - Hydralazine + Isosorbide dinitrate

Question 3

Second line in heart failure?

Answer 3

Spironolactone

Eplerenone after acute MI with LVSD or mild HF

Alternative:

Hydralazine + Isosorbide dinitrate (africans)
ARB
Sacubutril Valsartan (LVEF <35%) and if ace dose is stable

Question 4

Third line in heart failure?

Answer 4

Ivabradine (sinus rythym and heart rate above 75bpm)

or

Digoxin - doesn’t reduce mortality

Question 5

How is fluid overload managed in HF?

Answer 5

Loop diuretics

Thiazides (except in egfr below 30)