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Heart Failure

HF

Heart failure occurs when the cardiovascular system is unable to meet the metabolic demands of the body, or when it can only do so at elevated filling pressures. Common causes include ischaemic heart disease, hypertension, valvular heart disease, diabetes mellitus, drugs or congenital heart disease


Presentation

Dyspnea, fatigue and swelling (in the ankles, feet, legs, abdomen) are some of the most common symptoms of heart failure [7]. The start of symptoms is heralded by feelings of tiredness or extremely short breath following any physical exertions.

The symptoms get worse as the condition continues and so the individual can begin to feel tired and short of breath after getting dressed or simply walking across the room. It will progress to a stage where the individual will be out of breath while lying flat.

Other common symtoms include continous cough, increased urinal urge especially at night, ascites, sudden weight gain, concentration difficulties, increased blood pressure and chest pain

The New York Heart Association (NYHA) classifies heart failure into classes based on functional limitations and severity: Class I (no limitation in any activities), Class II (mild observable symptoms and slight limitation during ordinary activity), Class III (marked limitation of any activity) and Class IV (severe limitations, symptoms occur at rest).

Fatigue
  • The results suggest that fatigue is a circular process in which the consequences of fatigue further exaggerate the experience. However, fatigue could be alleviated by restorative activities.[dx.doi.org]
  • Excerpt: " Heart failure (HF) is a clinical syndrome that occurs in patients who, because of an inherited or acquired abnormality of cardiac structure and/or function, develop a constellation of clinical symptoms (dyspnea and fatigue) and signs (edema[web.archive.org]
  • HF is a shared chronic phase of cardiac functional impairment secondary to many aetiologies, and patients with HF experience a range of symptoms that affect their quality of life, including dyspnoea, fatigue, poor exercise tolerance and fluid retention[radcliffecardiology.com]
  • Key symptoms may include shortness of breath, a dry and hacking cough, weight gain, swelling, and fatigue. Detection and Diagnosis Detecting and diagnosing heart failure includes a complete physical exam, blood tests, and heart imaging.[intermountainhealthcare.org]
Weakness
  • There are many causes of congestive heart failure including: (1) coronary artery disease leading to heart attacks and heart muscle weakness, (2) primary heart muscle weakness from viral infections or toxins such as prolonged alcohol exposure, (3) heart[medterms.com]
  • Dizziness, fatigue, and weakness. Less blood to your major organs and muscles makes you feel tired and weak. Less blood to the brain can cause dizziness or confusion. Rapid or irregular heartbeats.[webmd.com]
  • The late HMR values showed a positive weak correlation with left ventricular ejection fraction (LVEF) in CCC and non-CCC (r 0.42 and p 0.045; and r 0.49 and p 0.015, respectively).[ncbi.nlm.nih.gov]
  • Over time, conditions such as narrowed arteries in your heart (coronary artery disease) or high blood pressure gradually leave your heart too weak or stiff to fill and pump efficiently.[web.archive.org]
  • Certain conditions, such as narrowed arteries in your heart (coronary artery disease) or high blood pressure, gradually leave your heart too weak or stiff to fill and pump efficiently.[mayoclinic.com]
Weight Gain
  • These data demonstrate that, on average, weight gain begins in a gradual fashion at least 1 week before heart failure hospitalization, but the present findings do not indicate that all admissions are preceded by weight gain.[dx.doi.org]
  • Key symptoms may include shortness of breath, a dry and hacking cough, weight gain, swelling, and fatigue. Detection and Diagnosis Detecting and diagnosing heart failure includes a complete physical exam, blood tests, and heart imaging.[intermountainhealthcare.org]
  • Weight gain, especially over a day or two, can be a sign that your body is holding on to extra fluid and your heart failure is getting worse. Talk to your provider about what you should do if your weight goes up or you develop more symptoms.[nlm.nih.gov]
Fever
  • Few cases report patients with heart failure, secondary to dilated cardiomyopathy, with high fever. A 23-month-old girl visited the emergency department with high fever, cough, first wheezing episode, chest retraction and tachycardia.[ncbi.nlm.nih.gov]
  • Abstract A 35-year-old woman with fever, edema and rash was admitted. Pleural effusion and cardiomegaly were observed. A laboratory analysis revealed anemia with iron deficiency and elevated human parvovirus B19 (B19V) immunoglobulin M.[ncbi.nlm.nih.gov]
  • She presented with a 2 month history of fever and a 2 weeks history of rapidly worsening shortness of breath. Emergency cardiac surgery was indicated which unfortunately could not be performed leading to the death of the patient.[ncbi.nlm.nih.gov]
  • Framingham Point Scores) NYHA Functional Classification for Congestive Heart Failure Cardiovascular Major Risk Factors Braunwald Classification of Unstable Angina (UA) Duke Criteria for Infective Endocarditis (IE) Revised Jones Criteria for Acute Rheumatic Fever[web.archive.org]
Amyloidosis
  • Abstract Cardiac amyloidosis may occur in any type of systemic amyloidosis. The clinical picture is often characterized by restrictive cardiomyopathy.[ncbi.nlm.nih.gov]
  • Cardiac MRI showed biventricular late gadolinium enhancement, and endomyocardial biopsy confirmed monoclonal immunoglobulin light-chain (AL) amyloidosis.[ncbi.nlm.nih.gov]
  • Amyloidosis Heart failure can also be caused by a rare group of conditions called amyloidosis.[bhf.org.uk]
  • […] as the blood backs up in the lungs Tiring easily Wheezing and spasms of the airways similar to asthma Causes of Heart Failure and Risk Factors Heart failure is generally the result of another disease, such as: A blood clot in an artery of the lungs Amyloidosis[cedars-sinai.edu]
  • […] disease results in a sudden blockage of a heart artery) Heart valves that are leaky or narrowed Infection that weakens the heart muscle Some types of abnormal heart rhythms (arrhythmias) Other diseases that can cause or contribute to heart failure: Amyloidosis[nlm.nih.gov]
Cough
  • A 23-month-old girl visited the emergency department with high fever, cough, first wheezing episode, chest retraction and tachycardia. The chest X-ray revealed consolidation on the left lower lung field; the cardiothoracic ratio was 60%.[ncbi.nlm.nih.gov]
  • Cough Most commonly a dry cough (without phlegm) More severe heart failure can cause a wet cough-coughing up pink, frothy fluid. Some people experience wheezing, similar to that caused by asthma.[northshore.org]
  • […] chest radiography) · Acute pulmonary edema · S3 gallop · Increased central venous pressure ( 16 cm H2O at right atrium) · Hepatojugular reflux · Weight loss 4.5 kg in 5 days in response to treatment Minor criteria: · Bilateral ankle edema · Nocturnal cough[web.archive.org]
  • Key symptoms may include shortness of breath, a dry and hacking cough, weight gain, swelling, and fatigue. Detection and Diagnosis Detecting and diagnosing heart failure includes a complete physical exam, blood tests, and heart imaging.[intermountainhealthcare.org]
Dyspnea
  • Compared with control group, there was no effect on dyspnea improvement. CONCLUSION: Serelaxin treatment is irrelevant with the mortality, and it cannot improve dyspnea of heart failure patients.[ncbi.nlm.nih.gov]
  • Major criteria: · Paroxysmal nocturnal dyspnea · Neck vein distention · Rales · Radiographic cardiomegaly (increasing heart size on chest radiography) · Acute pulmonary edema · S3 gallop · Increased central venous pressure ( 16 cm H2O at right atrium)[web.archive.org]
  • Abstract A 49-year-old Japanese man with worsening dyspnea was admitted with the diagnosis of new-onset heart failure (HF). His HF symptoms improved with standard treatment, but his left ventricular ejection fraction (LVEF) 21% remained unchanged.[ncbi.nlm.nih.gov]
  • Excerpt: " Heart failure (HF) is a clinical syndrome that occurs in patients who, because of an inherited or acquired abnormality of cardiac structure and/or function, develop a constellation of clinical symptoms (dyspnea and fatigue) and signs (edema[web.archive.org]
Rales
  • Excerpt: " Heart failure (HF) is a clinical syndrome that occurs in patients who, because of an inherited or acquired abnormality of cardiac structure and/or function, develop a constellation of clinical symptoms (dyspnea and fatigue) and signs (edema and rales[web.archive.org]
  • Major criteria: · Paroxysmal nocturnal dyspnea · Neck vein distention · Rales · Radiographic cardiomegaly (increasing heart size on chest radiography) · Acute pulmonary edema · S3 gallop · Increased central venous pressure ( 16 cm H2O at right atrium)[web.archive.org]
  • […] artery disease possibly has to be excluded in coronary angiography. 7.3 Diagnostics of the secondary symptoms Diagnostics of an eventual Overhydration (clinical exam: Edemas up to anasarca, ascites ) Pulmonary edema (clinical exam: dispnea, bilateral rales[flexikon.doccheck.com]
  • Typical signs: tachycardia, tachypnoea, pulmonary rales, pleural effusion, raised jugular venous pressure (JVP), peripheral oedema, hepatomegaly.[patient.info]
Orthopnea
  • Heart failure patients without sleep apnea have difficulty maintaining sleep, which may be fragmented by nocturia, orthopnea and paroxysmal nocturnal dyspnea, waking up the patient with shortness of breath.[web.archive.org]
  • These include, among others: Dyspnea ( exertional-, dyspnea at rest, orthopnea, paroxysmal nocturnal dyspnea); Fatigue, inadequate exhaustion after stress, weakness, lethargy Fluid retention (swelling of the legs or abdomen, weight gain), nocturia Dry[flexikon.doccheck.com]
  • The diagnosis of heart failure was based on current or past clinical symptoms (limitation of activity, fatigue, and dyspnea or orthopnea), signs (edema, elevated jugular venous pressure, rales, or S 3 gallop), or radiologic evidence of pulmonary congestion[dx.doi.org]
Exertional Dyspnea
  • Here we present an 80-year-old Asian woman complaining of progressive exertional dyspnea. She was diagnosed with acute decompensated heart failure and kidney injury due to severely calcified stenosis of the thoracoabdominal aorta, the so called AAC.[ncbi.nlm.nih.gov]
  • These include, among others: Dyspnea ( exertional-, dyspnea at rest, orthopnea, paroxysmal nocturnal dyspnea); Fatigue, inadequate exhaustion after stress, weakness, lethargy Fluid retention (swelling of the legs or abdomen, weight gain), nocturia Dry[flexikon.doccheck.com]
Nausea
  • Bloating in your stomach may cause a loss of appetite or nausea. Dizziness, fatigue, and weakness. Less blood to your major organs and muscles makes you feel tired and weak. Less blood to the brain can cause dizziness or confusion.[webmd.com]
  • , abdominal swelling, tenderness or pain (may result from the buildup of fluid in the body and the backup of blood in the liver) Weight gain (due to fluid buildup) Weight loss as nausea causes a loss of appetite and as the body fails to absorb food well[cedars-sinai.edu]
  • Stomach, which causes decreased appetite, bloating, and nausea. Intestines, which causes decreased appetite and poor absorption of medicines and food. Abdominal cavity ascites, tenderness, or fever can indicate an infection in this fluid buildup.[northshore.org]
  • Lack of Appetite or Nausea — When the liver and digestive system become congested they fail to receive a normal supply of blood. This can make you feel nauseous or full, even if you haven't eaten.[web.archive.org]
Abdominal Bloating
  • Backup of blood and fluid into the lungs Abdominal bloating Abdominal bloating can result from fluid backup in your: Liver, which makes your abdomen feel swollen or tender. Stomach, which causes decreased appetite, bloating, and nausea.[northshore.org]
  • An exacerbation of heart failure can be heralded by dyspnoea with usual daily activities, reduced exercise tolerance, abdominal bloating and poor appetite. Patients should know the weight at which their condition was previously stable.[nps.org.au]
Heart Failure
  • You can't reverse many conditions that lead to heart failure, but heart failure can often be treated with good results. Medications can improve the signs and symptoms of heart failure.[web.archive.org]
  • Therapeutic developments mean that patients with acute right heart failure survive to hospital discharge and live with chronic right heart failure.[ncbi.nlm.nih.gov]
  • failure; Left-sided heart failure; Right-sided heart failure - cor pulmonale; Cardiomyopathy - heart failure; HF Allen LA and Stevenson LW.[nlm.nih.gov]
Chest Pain
  • Seek emergency treatment if you experience any of the following: Chest pain Fainting or severe weakness Rapid or irregular heartbeat associated with shortness of breath, chest pain or fainting Sudden, severe shortness of breath and coughing up pink, foamy[mayoclinic.com]
  • pain if your heart failure is caused by a heart attack Patients experiencing heart attack symptoms should call 9-1-1 for emergency care.[capecodhealth.org]
  • pain or discomfort in parts of the upper body unexplained coughing and wheezing loss of appetite constipation.[betterhealth.vic.gov.au]
  • Other common symtoms include continous cough, increased urinal urge especially at night, ascites, sudden weight gain, concentration difficulties, increased blood pressure and chest pain.[symptoma.com]
  • Shortness of breath, chest pain, dizziness, or feeling faint may also occur with arrhythmias.[womenheart.org]
Tachycardia
  • Bilateral sympathectomy can be more effective than unilateral sympathectomy or percutaneous stellate ganglion blockade in patients with refractory ventricular tachycardia.[ncbi.nlm.nih.gov]
  • Renal failure may also occur following heart transplantation as a result of long-term immunosuppression. [3] Cardiac rhythm disorders may be caused by the following: Complete heart block Supraventricular tachycardia Ventricular tachycardia Sinus node[emedicine.com]
  • An 84-year-old woman was admitted to our hospital due to acute exacerbation of chronic heart failure and marked tachycardia with atrial fibrillation.[ncbi.nlm.nih.gov]
  • A 23-month-old girl visited the emergency department with high fever, cough, first wheezing episode, chest retraction and tachycardia. The chest X-ray revealed consolidation on the left lower lung field; the cardiothoracic ratio was 60%.[ncbi.nlm.nih.gov]
Palpitations
  • We report a case of heart failure in a 35-year-old man who presented with palpitations. Two-dimensional echocardiograms revealed left ventricular noncompaction, which markedly improved after standard heart failure therapy.[ncbi.nlm.nih.gov]
  • Abstract A 35-year-old Japanese man was emergently admitted to our hospital with chief complaints of palpitation and dyspnea. He has been treated for Basedow's disease.[ncbi.nlm.nih.gov]
  • […] of breath during physical activity Difficulty breathing when lying in a flat position Waking at night feeling short of breath Swollen neck ( jugular ) veins Abdominal swelling ( ascites ) from excess fluid Lower leg or foot swelling ( pedal edema ) Palpitations[dx.doi.org]
  • […] failure Symptoms of heart failure include: new or worsening shortness of breath (particularly during physical activity or waking you up at night) weight gain muscular fatigue, tiredness swelling of ankles or legs swelling of abdomen dizziness heart palpitations[betterhealth.vic.gov.au]
Cardiomegaly
  • Pleural effusion and cardiomegaly were observed. A laboratory analysis revealed anemia with iron deficiency and elevated human parvovirus B19 (B19V) immunoglobulin M.[ncbi.nlm.nih.gov]
  • Major criteria: · Paroxysmal nocturnal dyspnea · Neck vein distention · Rales · Radiographic cardiomegaly (increasing heart size on chest radiography) · Acute pulmonary edema · S3 gallop · Increased central venous pressure ( 16 cm H2O at right atrium)[web.archive.org]
  • Clinically there was no cardiomegaly and heart sounds were slightly muffled with gallop rhythm. Bilateral basal fine end inspiratory crackles and mild hepatosplenomegaly were noted.[ncbi.nlm.nih.gov]
  • The heart’s response to the systemic effects of circulatory failure is to enlarge the chambers (cardiomegaly) and increase the muscle mass (hypertrophy). Treatment of heart failure is complex and multifaceted.[britannica.com]
Hepatomegaly
  • We report the case of a 41-year-old female patient admitted to the Department of Cardiology with clinical signs of right heart failure: congested jugular veins, hepatomegaly, peripheral edema, ascites associated with atrial fibrillation, low values of[ncbi.nlm.nih.gov]
  • […] edema · S3 gallop · Increased central venous pressure ( 16 cm H2O at right atrium) · Hepatojugular reflux · Weight loss 4.5 kg in 5 days in response to treatment Minor criteria: · Bilateral ankle edema · Nocturnal cough · Dyspnea on ordinary exertion · Hepatomegaly[web.archive.org]
  • Typical signs: tachycardia, tachypnoea, pulmonary rales, pleural effusion, raised jugular venous pressure (JVP), peripheral oedema, hepatomegaly.[patient.info]
Jaundice
  • […] and perinatal jaundice 33 35 88 89 1 Pneumonia (except that caused by tuberculosis and sexually transmitted diseases) 55 25 148 61 -59 Short gestation, low birth weight, and fetal growth retardation 22 20 59 50 -16 1-17 years, total stays 1,821 1,402[web.archive.org]
Flushing
  • […] feeding, playing, or exercising Breathing difficulty with activity, especially while feeding, walking, or climbing stairs Loss of muscle mass Failure to gain weight Change in skin temperature and color (tendency to become cold and clammy, or sweaty, flushed[stanfordchildrens.org]
  • Main side effects are taste disturbances, while less common side effects are nausea, vomiting, abdominal pain, diarrhoea, flushing, bronchospasm, fever, myalgia and injection site reactions.[web.archive.org]
  • You might experience a hot flush (lasting a few seconds) in the area being examined when contrast medium is injected.[web.archive.org]
Nocturia
  • Similarly, patients with sleep apnea without heart failure have frequent awakenings, nocturia and may wake up short of breath due to the apnea.[web.archive.org]
  • These include, among others: Dyspnea ( exertional-, dyspnea at rest, orthopnea, paroxysmal nocturnal dyspnea); Fatigue, inadequate exhaustion after stress, weakness, lethargy Fluid retention (swelling of the legs or abdomen, weight gain), nocturia Dry[flexikon.doccheck.com]
Oliguria
  • […] year-old female patient admitted to the Department of Cardiology with clinical signs of right heart failure: congested jugular veins, hepatomegaly, peripheral edema, ascites associated with atrial fibrillation, low values of arterial blood pressure and oliguria[ncbi.nlm.nih.gov]
Dizziness
  • Dizziness, fatigue, and weakness. Less blood to your major organs and muscles makes you feel tired and weak. Less blood to the brain can cause dizziness or confusion. Rapid or irregular heartbeats.[webmd.com]
  • Any new palpitations or dizziness should be reported. Sometimes the dizziness may be related to the tablets you are taking. However you should report any dizziness to your doctor.[irishheart.ie]
  • Lightheadedness is a sensation of dizziness or mild disorientation. People with heart failure may also experience lightheadedness as a side effect of certain medications.[northshore.org]
  • Symptoms of heart failure Symptoms of heart failure include: new or worsening shortness of breath (particularly during physical activity or waking you up at night) weight gain muscular fatigue, tiredness swelling of ankles or legs swelling of abdomen dizziness[betterhealth.vic.gov.au]
  • When body tissues, such as organs and muscles, do not receive enough oxygen and nutrients, they cannot function well, leading to tiredness and dizziness.[singhealth.com.sg]
Confusion
  • In addition, the confusion of similar terms with HFpEF, such as diastolic heart failure, and diastolic dysfunction (DD), has led to a misunderstanding of the true scope of HFpEF.[ncbi.nlm.nih.gov]
  • The term ‘failure’ can be confusing – the heart does not actually stop pumping. However, the heart is less effective at both delivering oxygen and nutrients to the rest of the body and carrying waste products away.[gosh.nhs.uk]
  • Without enough blood, the brain does not function well, resulting in lightheadedness and/or mental confusion. Lightheadedness is a sensation of dizziness or mild disorientation.[northshore.org]
  • Less blood to the brain can cause dizziness or confusion. Rapid or irregular heartbeats. The heart beats faster to pump enough blood to the body. This can cause a fast or irregular heartbeat.[webmd.com]
  • […] including: Shortness of breath Swelling of the feet and legs Lack of energy, feeling tired Difficulty sleeping at night due to breathing problems Swollen or tender abdomen, loss of appetite Cough with "frothy" mucus or phlegm Increased urination at night Confusion[medtronic.com]
Headache
  • No serious adverse events occurred in either group; however, constipation, headaches, and hypotension were more frequent in the conivaptan arms.[uscjournal.com]
  • Nervous System and Sense Organs 76 Meningitis 32,909 2,565 7.8 77 Encephalitis 8,487 1,219 14.4 79 Parkinson's disease 13,089 2,118 16.2 80 Multiple sclerosis 21,708 2,529 11.6 82 Paralysis 7,394 987 13.3 83 Epilepsy, convulsions 252,200 31,965 12.7 84 Headache[hcup-us.ahrq.gov]
Vertigo
  • 10.4 85 Coma, stupor, and brain damage 16,823 2,740 16.3 89 Blindness and vision defects 5,364 521 9.7 90 Inflammation, infection of eye 15,984 1,201 7.5 92 Otitis media and related conditions 9,855 738 7.5 93 Conditions associated with dizziness or vertigo[hcup-us.ahrq.gov]

Workup

Proper evaluation of the patient’s history as well as physical checks for signs of congestion such as jugular venous distention can bring about the underlying cardiac abnormality in heart failure [8]. It may however, be needful to subject the individual to other tests and studies to pinpoint conditions or systemic abnormalities that may either lead to or exacerbate heart failure.

Diagnostic procedures for clearer diagnosis include:

  • Blood tests
  • Chest X-ray
  • Electrocardiogram (ECG)
  • Echocardiogram
  • Ejection fraction.
  • Stress test
  • Cardiac computerized tomography (CT) scan or magnetic resonance imaging (MRI)
  • Coronary catheterization (Angiogram)
  • Myocardial biopsy
Pericardial Effusion
  • Heart failure was evident on chest X-ray and 2D-echocardiogram showed global left ventricular hypokinesia with 40% ejection fraction and a thin layer of pericardial effusion.[ncbi.nlm.nih.gov]

Treatment

Treatment of heart failure is focused on improving symptoms and also interfering with the pathophysiology of the condition [9]. Reversible causes of the condition, such as infection, alcohol ingestion, anemia or hypertension need to be addressed.

Treatments include lifestyle and pharmacological modalities. Device therapy is used in some cases and on rare occasions, cardiac transplantation may be needful.

Prognosis

Generally, mortality as a result of hospitalization in patients with heart failure is 10.4% at 30 days, 22% at 1 year and 42.3% at 5 years [6]. This is regardless of the sharp improvement in medical solutions. When there is a rehospitalisation, the chances of mortality increases by a further 20 to 22%.

Etiology

In many cases, heart failure is caused by coronary heart disease (CHD), high blood pressure, and diabetes. Treating these problems can improve the condition of heart failure patients. Other possible etiologic factors include: 

Epidemiology

Heart failure is a condition that occurs worldwide [4]. In the United States, heart failure affects around 5.7 million Americans of all ages and sexes. It is also responsible for more hospitalisations than all forms of cancer.

In industrialised countries the common cause of heart failure is ischemic cardiomyopathy. In developing countries, Chagas disease and valvular cardiomyopathy are the most common causes.

Data in developing nations are not as complete as what is obtainable in the Western world.

Sex distribution
Age distribution

Pathophysiology

Heart failure refers to any condition that reduces the efficiency of the myocardium through damage or overloading [5]. It can be caused by a wide range of conditions. These etiologic factors affect the heart in various ways and cause an increase in workload which ends up producing changes to the heart. 

All of these lead to the general effect of reduced cardiac output, causing an increased strain on the heart. It increases the risk of cardiac arrest especially as a result of ventricular dysrhythmias and brings about a reduction in blood supply to other areas of the body.

Prevention

The major key to the prevention of heart failure is reduction of the risk factors. The risk factors of heart failure can be eliminated by making lifestyle changes and with the help of relevant medications. Lifestyle changes that can help in prevention of heart failure include [10]:

  • Cessation of smoking 
  • Adherence to treatment of high cholesterol, diabetes or high blood pressure
  • Remaining physically active
  • Consumption of healthy foods
  • Maintenance of a healthy weight
  • Reduction and management of stress

Summary

Heart failure is a condition in which the heart is unable to meet the metabolic of the body, or when it can only do so at elevated filling pressures. [1].

Heart failure develops over time as the pumping action of the heart grows weaker. The condition can affect the right side of the heart only or the left side only. In majority of cases however, both sides of the heart are affected [2].

Right-side heart failure happens when the heart can’t pump enough blood to the lungs to gather oxygen. Left-side heart failure occurs when the heart is unable to pump oxygen rich blood to other parts of the body.

Patient Information

Heart failure happens, when the heart muscle is unable to pump enough blood as is supposed. Conditions like thinned down arteries in the heart or high blood pressure end up leaving the heart too weak or stiff to fill and pump efficiently.

Only some of the conditions that lead to heart failure can be reversed but treatments can improve the signs and symptoms of heart failure allowing most people to it to live much longer. In people with risk of heart failure, making life style changes such as exercise, reduction of salt consumption or weight loss can lead to improvement in quality of life.

Preventing heart failure depends on the control of conditions that lead to it such as coronary artery disease, high blood pressure, obesity and diabetes.

References

Article

  1. Braunwald E. The pathogenesis of heart failure: Then and now. Medicine. 1991;70:68.
  2. Braunwald E, Ross J Jr, Sonnenblick EH. 2 ed. Mechanisms of Contraction of the Normal and Failing Heart. Boston: Little Brown & Co; 1976:417.
  3. Clifford R Greyson, MD. Pathophysiology of right ventricular failure. Crit Care Med. 2008;36(suppl):S57-65.
  4. Haddad F, Doyle R, Murphy DJ, Hunt SA. Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure. Circulation. Apr 1 2008;117(13):1717-31.
  5. Onwuanyi A, Taylor M. Acute decompensated heart failure: pathophysiology and treatment. Am J Cardiol. Mar 26 2007;99(6B):25D-30D.
  6. Ho KK, Pinsky JL, Kannel WB, Levy D. The epidemiology of heart failure: the Framingham Study. J Am Coll Cardiol 1993; 22:6A.
  7. Cowie MR, Mosterd A, Wood DA, et al. The epidemiology of heart failure. Eur Heart J 1997; 18:208.
  8. Hoes AW, Mosterd A, Grobbee DE. An epidemic of heart failure? Recent evidence from Europe. Eur Heart J 1998; 19 Suppl L:L2.
  9. Bonneux L, Barendregt JJ, Meeter K, et al. Estimating clinical morbidity due to ischemic heart disease and congestive heart failure: the future rise of heart failure. Am J Public Health 1994; 84:20.
  10. Mosterd A, Deckers JW, Hoes AW, et al. Classification of heart failure in population based research: an assessment of six heart failure scores. Eur J Epidemiol 1997; 13:491.

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Last updated: 2018-06-22 11:51