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What is cor pulmonale?
Chronic RHF
In a patient with suspected heart failure, what signs are you looking for on *physical examination*?
Blood pressure (hypertension)
Peripheral pulses / bruits (atheromatous disease)
Optic fundi (hypertensive retinopathy)
Apex beat (lateral displacement)
Auscultation of the heart (S3 and/or S4)
Auscultation of the lungs (Persistent crackles)
Percussion of the lung bases (effusion)
Lower Limbs (edema)
Sacrum (edema)
JVP
Liver (hepatomegaly with hepato-jugular reflux
Abdomen (ascites)
BMI (obesity)
In a patient with suspected heart failure, what specific questions do you want to ask during history taking?
Previous MI?
Hypertension?
Rheumatic Fever?
Previously known heart murmur?
and occasionally,
Anaemia
Thyroid disease
Drug-induced (beta-blockers)
What is the normal range for ejection fraction?
60-70%
Common signs of heart failure?
New onset shortness of breath (dyspnoea)
Orthopnoea
Paroxysmal Noctural Dyspnoea (accompanied by pink frothy sputum)
Decreased exercise tolerance
Unexplained confusion in the elderly
Nausea or abdominal pain
What are common causes of left ventricular failure (LVF)?
Third heart sound (2/3 of people with LVF)
Laterally displaced apex beat (1/3 of people with LVF)
Crepitations at the lung bases
Wheeze (caused by airway compression due to bronchial edema)
Acute murmur (e.g. mitral regurgitation)
