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Heart Failure

Heart Failure

is a common clinical syndrome that results from the impaired ability of the ventricle to fill with or eject blood.

The term heart failure is preferred over the older term congestive heart failure because not all patients with heart failure have volume overload.

Stages of Heart Failure

Stages of Heart Failure

Terminology related to left ventricular ejection fraction

Classification

Ejection

Description

Fraction

I. Heart Failure with Reduced Ejection Fraction (HFrEF)

≤40%

Also referred to as systolic HF. Randomized clinical trials have mainly enrolled patients with HFrEF and it is only in these patients that efficacious therapies have been demonstrated to date.

II. Heart Failure with Preserved Ejection Fraction (HFpEF)

≥50%

Also referred to as diastolic HF. Several different criteria have been used to further define HFpEF. The diagnosis of HFpEF is challenging because it is largely one of excluding other potential noncardiac causes of symptoms suggestive of HF. To date, efficacious therapies have not been identified.

Diagnosis of HF Requires:

  • 2 major criteria or

  • 1 major criteria + 2 minor criteria, (provided that the minor criteria are not attributed to another medical condition

Pathophysiology

Pathophysiology
ESC guidelines 2012

ESC guidelines 2012

ESC guidelines 2012

ACUTE HEART FAILURE

ACUTE HEART FAILURE

  • The term used to describe the rapid onset of, or change in, symptoms & signs of HF

  • Life threatening condition requires immediate medical attention

  • In most cases, AHF arises as a result of deterioration in patients with a previous diagnosis of HF there is often a clear precipitant/ trigger (arrhythmia, discontinuation of diuretic, volume overload or severe hypertension)

  • May also be the first presentation of HF (‘de novo’ AHF).

Precipitants & causes of AHF

Goals of treatment in AHF

Goals of treatment in AHF

Terima Kasih