Early signs • NYHA classification • Treatment algorithm • Drugs & decisions
A 62-year-old man with prior MI complains of exertional breathlessness. Echo shows LVEF 32%. He is on ACE inhibitor and beta-blocker. HR = 78/min, BNP is elevated. Which additional drug will further reduce HF mortality?
A 55-year-old woman has shortness of breath on climbing a single flight of stairs. She is comfortable at rest but has marked limitation for daily tasks. What is her NYHA functional class?
A patient with HFrEF on ACE inhibitor develops a persistent dry cough. Echo shows EF 30%. What is the most appropriate replacement?
A 70-year-old man presents with acute severe dyspnea, frothy sputum and BP 170/100 mmHg. On exam he has bilateral crepitations. What is the first-line acute therapy?
A 50-year-old diabetic with EF 38% is on ARNI, beta-blocker and spironolactone. Which additional drug reduces HF mortality and works even in non-diabetics?
A patient on spironolactone for HF presents with muscle weakness and ECG showing peaked T waves. Which abnormal lab value is most likely?
A 65-year-old man with HFrEF (EF 28%) has HR 82/min despite maximum tolerated beta-blocker. Which drug specifically acts on SA node “funny current” (If) to lower heart rate?
A patient with HFrEF is to be started on sacubitril/valsartan (ARNI). He is currently on an ACE inhibitor. What is the correct approach?
A 58-year-old man with orthopnea and PND has suspected HF. On chest X-ray, what is an early sign of pulmonary venous congestion?
A 52-year-old woman with long-standing hypertension presents with exertional dyspnea. Echo shows preserved EF with concentric LVH. Which is the best treatment strategy?
A HF patient is started on furosemide. Which electrolyte disturbance is most typical?
A dyspneic patient has raised BNP but echocardiography reveals normal EF with diastolic dysfunction. What is the likely diagnosis?
A HF patient given high-dose ACE inhibitor develops symptomatic hypotension. What is the key mechanism?
A HF patient on carvedilol comes with BP 86/60 mmHg and dizziness. What is the most appropriate change in therapy?
A 67-year-old man reports severe dyspnea at rest and is unable to perform any physical activity without discomfort. NYHA class?
A patient on digoxin develops nausea, yellow vision and ventricular arrhythmias. Which electrolyte abnormality predisposes to this toxicity?
A HF patient presents with raised JVP, tender hepatomegaly and bilateral pitting edema, but minimal pulmonary crepitations. What does this most likely indicate?
A 45-year-old with EF 25% can perform ordinary activities with only mild limitation. He has dyspnea on more than ordinary exertion but not at rest. Current NYHA class?
A HF patient on SGLT2 inhibitor develops mild recurrent genital mycotic infections. He otherwise feels much better and wants to continue. Best approach?
A HF patient suddenly develops pink frothy sputum and severe breathlessness. What is the underlying pathophysiology?
A known HF patient gains 3 kg over 3 days and complains of worsening ankle swelling. What is the most appropriate immediate adjustment?
Which drug in HF simultaneously reduces both preload and afterload by venous and arterial vasodilation, especially useful in acute pulmonary edema?
A man on spironolactone for HF complains of painful breast enlargement. What is the mechanism behind this adverse effect?
A patient with HFrEF is started on verapamil for rate control. What is the likely effect on his HF?
A 75-year-old diabetic with HFpEF has BP 150/92 mmHg. Which class is preferred as baseline BP control with prognostic benefit?
A patient with HFrEF is mistakenly given sacubitril/valsartan together with an ACE inhibitor. Which complication is particularly feared with this combination?
A HF patient with EF 20%, repeated hospitalizations and QRS duration 160 ms has LBBB pattern. Which device therapy improves survival by resynchronizing ventricles?
A chronic HF patient is found to have hyponatremia (Na⁺ 124 mEq/L). What is the main mechanism in HF-related dilutional hyponatremia?
A 60-year-old HF patient presents with cold clammy extremities, confusion, and systolic BP 75 mmHg. Which diagnosis best fits this hemodynamic state?
A 50-year-old man with EF 30% is stable on guideline-directed therapy but has reduced exercise tolerance. Which drug improves symptoms and reduces hospitalization but does not reduce mortality?