Heart failure - Knowledge

1828:. The NYHA functional classes (I–IV) begin with class I, which is defined as a person who experiences no limitation in any activities and has no symptoms from ordinary activities. People with NYHA class II heart failure have slight, mild limitations with everyday activities; the person is comfortable at rest or with mild exertion. With NYHA class III heart failure, a marked limitation occurs with any activity; the person is comfortable only at rest. A person with NYHA class IV heart failure is symptomatic at rest and becomes quite uncomfortable with any physical activity. This score documents the severity of symptoms and can be used to assess response to treatment. While its use is widespread, the NYHA score is not very reproducible and does not reliably predict the walking distance or exercise tolerance on formal testing. 1574: 1892: 1558: 1933:(the recommended minimum by U.S. guidelines) had lower heart failure risk than individuals who did not report exercising during their free time; the reduction in heart failure risk was even greater in those who engaged in higher levels of physical activity than the recommended minimum. Heart failure can also be prevented by lowering high blood pressure and high blood cholesterol, and by controlling diabetes. Maintaining a healthy weight, and decreasing sodium, alcohol, and sugar intake, may help. Additionally, avoiding tobacco use has been shown to lower the risk of heart failure. 6331:"ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society" 2571:

hospital readmissions in the U.S. People aged 65 and older were readmitted at a rate of 24.5 per 100 admissions in 2011. In the same year, heart failure patients under Medicaid were readmitted at a rate of 30.4 per 100 admissions, and uninsured people were readmitted at a rate of 16.8 per 100 admissions. These are the highest readmission rates for both categories. Notably, heart failure was not among the top-10 conditions with the most 30-day readmissions among the privately insured.

1187: 1646: 1634: 940: 60: 1104:, and decreasing a person's response to diuretic medications. Similarly, the ACC/AHA recommends against the use of COX-2 inhibitor medications in people with heart failure. Thiazolidinediones have been strongly linked to new cases of heart failure and worsening of pre-existing congestive heart failure due to their association with weight gain and fluid retention. Certain calcium channel blockers, such as 651: 10096: 2567:

adults at age 40 will develop heart failure during their remaining lifetimes and about half of people who develop heart failure die within 5 years of diagnosis. Heart failure – much higher in African Americans, Hispanics, Native Americans, and recent immigrants from Eastern Europe countries – has been linked in these ethnic minority populations to high incidence of diabetes and hypertension.

1540: 1522: 1504: 1486: 2440:(CRT) can initiate a normal sequence of ventricular depolarization. In people with LVEF below 35% and prolonged QRS duration on ECG (LBBB or QRS of 150 ms or more), an improvement in symptoms and mortality occurs when CRT is added to standard medical therapy. However, in the two-thirds of people without prolonged QRS duration, CRT may actually be harmful. 716:(frequent night-time urination) may occur when fluid from the legs is returned to the bloodstream while lying down at night. In progressively severe cases, ascites (fluid accumulation in the abdominal cavity causing swelling) and liver enlargement may develop. Significant liver congestion may result in impaired liver function ( 1708:(BNP) is another biomarker commonly tested for heart failure. An elevated NT-proBNP or BNP is a specific test indicative of heart failure. Additionally, NT-proBNP or BNP can be used to differentiate between causes of dyspnea due to heart failure from other causes of dyspnea. If myocardial infarction is suspected, various 1945:

blood pressure can be lowered into the normal range by making dietary decisions such as consuming less salt. Exercise also helps to bring blood pressure back down. One of the best ways to help avoid heart failure is to promote healthier eating habits like eating more vegetables, fruits, grains, and lean protein.

4383:"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC" 2570:

Nearly one of every four people (24.7%) hospitalized in the U.S. with congestive heart failure are readmitted within 30 days. Additionally, more than 50% of people seek readmission within 6 months after treatment and the average duration of hospital stay is 6 days. Heart failure is a leading cause of

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Without transplantation, heart failure may not be reversible and heart function typically deteriorates with time. The growing number of people with stage IV heart failure (intractable symptoms of fatigue, shortness of breath, or chest pain at rest despite optimal medical therapy) should be considered

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is one such medication. Its narrow therapeutic window, a high degree of toxicity, and the failure of multiple trials to show a mortality benefit have reduced its role in clinical practice. It is now used in only a small number of people with refractory symptoms, who are in atrial fibrillation, and/or

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Rates are predicted to increase. Increasing rates are mostly because of increasing lifespan, but also because of increased risk factors (hypertension, diabetes, dyslipidemia, and obesity) and improved survival rates from other types of cardiovascular disease (myocardial infarction, valvular disease,

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below 35% have markedly altered conduction to the ventricles, resulting in dyssynchronous depolarization of the right and left ventricles. This is especially problematic in people with left bundle branch block (blockage of one of the two primary conducting fiber bundles that originate at the base of

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In people with severe cardiomyopathy (left ventricular ejection fraction below 35%), or in those with recurrent VT or malignant arrhythmias, treatment with an automatic implantable cardioverter-defibrillator (AICD) is indicated to reduce the risk of severe life-threatening arrhythmias. The AICD does

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The ACC staging system is useful since stage A encompasses "pre-heart failure" – a stage where intervention with treatment can presumably prevent progression to overt symptoms. ACC stage A does not have a corresponding NYHA class. ACC stage B would correspond to NYHA class I. ACC stage C corresponds

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levels are usually increased, along with renin, angiotensin II, and catecholamines to compensate for reduced circulating volume due to inadequate cardiac output. This leads to increased fluid and sodium retention in the body; the rate of fluid retention is higher than the rate of sodium retention in

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defines heart failure as symptoms and signs consistent with heart failure in combination with shown "structural and functional alterations of the heart as the underlying cause for the clinical presentation", for HFmrEF and HFpEF specifically requiring "evidence of spontaneous or provokable increased

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A very important method for assessing prognosis in people with advanced heart failure is cardiopulmonary exercise testing (CPX testing). CPX testing is usually required prior to heart transplantation as an indicator of prognosis. CPX testing involves measurement of exhaled oxygen and carbon dioxide

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In select cases, heart transplantation can be considered. While this may resolve the problems associated with heart failure, the person must generally remain on an immunosuppressive regimen to prevent rejection, which has its own significant downsides. A major limitation of this treatment option is

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is recommended for people with symptomatic heart failure with reduced left ventricular ejection fraction who are receiving optimized guideline-directed therapy (as above) including the maximum tolerated dose of beta-blocker, have a normal heart rhythm and continue to have a resting heart rate above

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Breast cancer patients are at high risk of heart failure due to several factors. After analysing data from 26 studies (836,301 patients), the recent meta-analysis found that breast cancer survivors demonstrated a higher risk heart failure within first ten years after diagnosis (hazard ratio = 1.21;

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in the first year after diagnosis is about 35%, while the risk of death in the second year is less than 10% in those still alive. The risk of death is comparable to that of some cancers. In the United Kingdom, the disease is the reason for 5% of emergency hospital admissions. Heart failure has been

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Diabetes is a major risk factor for heart failure. For women with Coronary Heart disease (CHD), diabetes was the strongest risk factor for heart failure. Diabetic women with depressed creatinine clearance or elevated BMI were at the highest risk of heart failure. While the annual incidence rate of

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In the United States, heart failure affects 5.8 million people, and each year 550,000 new cases are diagnosed. In 2011, heart failure was the most common reason for hospitalization for adults aged 85 years and older, and the second-most common for adults aged 65–84 years. An estimated one in five

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People with heart failure often have significant symptoms, such as shortness of breath and chest pain. Palliative care should be initiated early in the HF trajectory, and should not be an option of last resort. Palliative care can not only provide symptom management, but also assist with advanced

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Gynura can cause low blood pressure. Licorice can worsen heart failure by increasing blood pressure and promoting fluid retention. Lily of the valley can cause abnormally slow heart rates with mechanisms similar to those of digoxin. Tetrandrine can lead to low blood pressure through inhibition of

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In the UK, despite moderate improvements in prevention, heart failure rates have increased due to population growth and ageing. Overall heart failure rates are similar to the four most common causes of cancer (breast, lung, prostate, and colon) combined. People from deprived backgrounds are more

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Heart failure is associated with significantly reduced physical and mental health, resulting in a markedly decreased quality of life. With the exception of heart failure caused by reversible conditions, the condition usually worsens with time. Although some people survive many years, progressive

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there are a few ways to help to prevent a cardiac event. Johns Hopkins states that stopping tobacco use, reducing high blood pressure, physical activity and your diet can drastically effect the chances of developing heart disease. High blood pressure accounts for most cardiovascular deaths. High

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Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG, et al. (April 2009). "2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on

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defines the diagnosis of heart failure as symptoms and signs consistent with heart failure in combination with "objective evidence of cardiac structural or functional abnormalities". This definition is consistent with an international 2021 report termed "Universal Definition of Heart Failure".

1164:. Aconite can cause abnormally slow heart rates and abnormal heart rhythms such as ventricular tachycardia. Ginseng can cause abnormally low or high blood pressure, and may interfere with the effects of diuretic medications. Gossypol can increase the effects of diuretics, leading to toxicity. 2529:

max <10 cc/kg/min have a clearly poorer prognosis. The most recent International Society for Heart and Lung Transplantation guidelines also suggest two other parameters that can be used for evaluation of prognosis in advanced heart failure, the heart failure survival score and the use of a

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The decision to anticoagulate people with HF, typically with left ventricular ejection fractions <35% is debated, but generally, people with coexisting atrial fibrillation, a prior embolic event, or conditions that increase the risk of an embolic event such as amyloidosis, left ventricular

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Exercise should be encouraged and tailored to suit individual's capabilities. A meta-analysis found that centre-based group interventions delivered by a physiotherapist are helpful in promoting physical activity in HF. There is a need for additional training for physiotherapists in delivering

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The latest evidence indicates that advance care planning (ACP) may help to increase documentation by medical staff regarding discussions with participants, and improve an individual's depression. This involves discussing an individual's future care plan in consideration of the individual's

1387:(HFpEF): Synonyms no longer recommended include "diastolic heart failure" and "heart failure with normal ejection fraction." HFpEF occurs when the left ventricle contracts normally during systole, but the ventricle is stiff and does not relax normally during diastole, which impairs filling. 747:

If a person with a failure of one ventricle lives long enough, it will tend to progress to failure of both ventricles. For example, left ventricular failure allows pulmonary edema and pulmonary hypertension to occur, which increase stress on the right ventricle. Though still harmful, right

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insufficiency of the left ventricle causes congestion in the blood vessels of the lungs, so that symptoms are predominantly respiratory. Reverse insufficiency can be divided into the failure of the left atrium, the left ventricle, or both within the left circuit. Patients will experience

1544: 1527: 1508: 1490: 2655:, for the treatment of dropsy; descriptions pertaining to heart failure are also known in the civilizations of ancient India and China. However, the manifestations of failing heart were understood in the context of these peoples' medical theories – including ancient Egyptian religion, 2226:

if the person develops a long-term cough as a side effect of the ACE-I, is associated with improved survival, fewer hospitalizations for heart failure exacerbations, and improved quality of life in people with heart failure. European guidelines published by ESC in 2021 recommends that

3804:"2012 ACCF/AHA/HRS focused update of the 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. [corrected]" 490: 8466:

Hobbs FD, Kenkre JE, Roalfe AK, Davis RC, Hare R, Davies MK (December 2002). "Impact of heart failure and left ventricular systolic dysfunction on quality of life: a cross-sectional study comparing common chronic cardiac and medical disorders and a representative adult population".

2697:(fluid accumulation in and round the lungs causing shortage of breath) became more familiar and the current concept of heart failure, which brings together swelling and shortage of breath due to fluid retention, began to be accepted, in the 17th and especially in the 18th century: 535:

Symptoms of heart failure are traditionally divided into left-sided and right-sided because the left and right ventricles supply different parts of the circulation. In biventricular heart failure, both sides of the heart are affected. Left-sided heart failure is the more common.

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Prognosis in heart failure can be assessed in multiple ways, including clinical prediction rules and cardiopulmonary exercise testing. Clinical prediction rules use a composite of clinical factors such as laboratory tests and blood pressure to estimate prognosis. Among several

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is more limited than in those who do not have it. If the ejection fraction is not diminished (HFpEF), the benefits of beta blockers are more modest; a decrease in mortality has been observed, but reduction in hospital admission for uncontrolled symptoms has not been observed.

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Giallauria F, Vigorito C, Piepoli MF, Stewart Coats AJ (August 2014). "Effects of cardiac contractility modulation by non-excitatory electrical stimulation on exercise capacity and quality of life: an individual patient's data meta-analysis of randomized controlled trials".

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may help. Although this research indicated benefits of stem cell therapy, other research does not indicate benefit. There is tentative evidence of longer life expectancy and improved left ventricular ejection fraction in persons treated with bone marrow-derived stem cells.

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A narrow pulse pressure — sometimes called a low pulse pressure — is where your pulse pressure is one-fourth or less of your systolic pressure (the top number). This happens when your heart isn't pumping enough blood, which is seen in heart failure and certain heart valve

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to relieve fluid accumulation and shortage of breath, and provided what may have been the first documented observations on heart failure in the Ebers papurus (around 1500 BCE); Greeks described cases of dyspnea, fluid retention and fatigue compatible with heart failure;

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Mehra MR, Kobashigawa J, Starling R, Russell S, Uber PA, Parameshwar J, et al. (September 2006). "Listing criteria for heart transplantation: International Society for Heart and Lung Transplantation guidelines for the care of cardiac transplant candidates – 2006".

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Anemia is an independent factor in mortality in people with chronic heart failure. Treatment of anemia significantly improves quality of life for those with heart failure, often with a reduction in severity of the NYHA classification, and also improves mortality rates.

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One historical method of categorizing heart failure is by the side of the heart involved (left heart failure versus right heart failure). Right heart failure was thought to compromise blood flow to the lungs compared to left heart failure compromising blood flow to the

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intake. Fluid restriction is important to reduce fluid retention in the body and to correct the hyponatremic status of the body. The evidence of benefit of reducing salt, however, is poor as of 2018. Thirst is a common and burdensome symptom for patients to cope with.

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the body, this phenomenon causes hypervolemic hyponatremia (low sodium concentration due to high body fluid retention). This phenomenon is more common in older women with low body mass. Severe hyponatremia can result in accumulation of fluid in the brain, causing

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refer to situations in which no cardiac output occurs at all. Without urgent treatment, these events result in sudden death. Myocardial infarction ("Heart attack") refers to heart muscle damage due to insufficient blood supply, usually as a result of a blocked

7725:"2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America" 2491:

for prognosticating acute heart failure, the 'EFFECT rule' slightly outperformed other rules in stratifying people and identifying those at low risk of death during hospitalization or within 30 days. Easy methods for identifying people that are low-risk are:

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Ewald B, Ewald D, Thakkinstian A, Attia J (February 2008). "Meta-analysis of B type natriuretic peptide and N-terminal pro B natriuretic peptide in the diagnosis of clinical heart failure and population screening for left ventricular systolic dysfunction".

2637:; the term denotes generalized edema, a major manifestation of a failing heart, though also caused by other diseases. Writings of ancient civilizations include evidence of their acquaintance with dropsy and heart failure: Egyptians were the first to use 5665:"2021 ACC/AHA Key Data Elements and Definitions for Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Heart Failure)" 2206:

There is no convincing evidence for pharmacological treatment of heart failure with preserved ejection fraction (HFpEF). Medication for HFpEF is symptomatic treatment with diuretics to treat congestion. Managing risk factors and comorbidities such as

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not improve symptoms or reduce the incidence of malignant arrhythmias but does reduce mortality from those arrhythmias, often in conjunction with antiarrhythmic medications. In people with left ventricular ejection (LVEF) below 35%, the incidence of

2048:. Treatment of the underlying cause is usually the first approach to treating heart failure. In the majority of cases, though, either no primary cause is found or treatment of the primary cause does not restore normal heart function. In these cases, 760:

and not a disease, establishing the underlying cause is vital to diagnosis and treatment. In heart failure, the structure or the function of the heart or in some cases both are altered. Heart failure is the potential end stage of all heart diseases.

532:, which is the difference between the systolic ("top number") and diastolic ("bottom number") blood pressures, is often low/narrow (i.e. 25% or less of the level of the systolic) in people with heart failure, and this can be an early warning sign. 5641: 2068:

and heart failure has been proposed with exercise training as a core component. Rehabilitation should also include other interventions to address shortness of breath including psychological and educational needs of people and needs of caregivers.

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Heart failure is a common, costly, and potentially fatal condition, and is the leading cause of hospitalization and readmission in older adults. Heart failure often leads to more drastic health impairments than failure of other, similarly complex

7686: 744:). Though it can occur in isolated left- or right-sided heart failure, it is more common in biventricular failure because pleural veins drain into both the systemic and pulmonary venous systems. When unilateral, effusions are often right-sided. 2507:

BWH rule indicates that people with systolic blood pressure over 90 mm Hg, respiratory rate of 30 or fewer breaths per minute, serum sodium over 135 mmol/L, and no new ST–T wave changes have less than 10% chance of inpatient death or

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duration (120 ms or less) and has been demonstrated to improve the symptoms, quality of life, and exercise tolerance. CCM is approved for use in Europe, and was approved by the Food and Drug Administration for use in the United States in 2019.

1975:, and hypertension). Treatments include lifestyle and pharmacological modalities, and occasionally various forms of device therapy. Rarely, cardiac transplantation is used as an effective treatment when heart failure has reached the end stage. 7509:

Zannad F, Ferreira JP, Pocock SJ, Anker SD, Butler J, Filippatos G, et al. (September 2020). "SGLT2 inhibitors in patients with heart failure with reduced ejection fraction: a meta-analysis of the EMPEROR-Reduced and DAPA-HF trials".

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route of administration and their side-effects. Oral mercurial diuretics were introduced in the 1950s; so were thiazide diuretics, which caused less toxicity, and are still used. Around the same time, the invention of echocardiography by

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Heart failure with reduced ejection fraction (HFrEF): Synonyms no longer recommended are "heart failure due to left ventricular systolic dysfunction" and "systolic heart failure". HFrEF is associated with an ejection fraction less than

469:, reducing cardiac output to the rest of the body. The filling failure and high intracardiac pressure can lead to fluid accumulation in ventricles of heart. This manifests as water retention and swelling due to fluid accumulation ( 5608: 6891: 2608:

Men have a higher incidence of heart failure, but the overall prevalence rate is similar in both sexes since women survive longer after the onset of heart failure. Women tend to be older when diagnosed with heart failure (after

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Around 18 of every 1000 persons will experience an ischemic stroke during the first year after diagnosis of HF. As the duration of follow-up increases, the stroke rate rises to nearly 50 strokes per 1000 cases of HF by 5 years.

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Fonarow GC, Abraham WT, Albert NM, Stough WG, Gheorghiade M, Greenberg BH, et al. (April 2008). "Factors identified as precipitating hospital admissions for heart failure and clinical outcomes: findings from OPTIMIZE-HF".

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is the preferred measure of systolic function. Normally, the EF should be between 50 and 70%; in systolic heart failure, it drops below 40%. Echocardiography can also identify valvular heart disease and assess the state of the

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Feltner C, Jones CD, Cené CW, Zheng ZJ, Sueta CA, Coker-Schwimmer EJ, et al. (June 2014). "Transitional care interventions to prevent readmissions for persons with heart failure: a systematic review and meta-analysis".

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such as the kidneys or liver. In 2015, it affected about 40 million people worldwide. Overall, heart failure affects about 2% of adults, and more than 10% of those over the age of 70. Rates are predicted to increase.

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Kuschyk J, Roeger S, Schneider R, Streitner F, Stach K, Rudic B, et al. (March 2015). "Efficacy and survival in patients with cardiac contractility modulation: long-term single center experience in 81 patients".

1422:. Cardiomyopathy refers specifically to problems within the heart muscle, and these problems can result in heart failure. Ischemic cardiomyopathy implies that the cause of muscle damage is coronary artery disease. 10164:

resource webpage with links to Full text and related materials, scientific presentation at ESC Congress 2021, news article, TV interview, app, slide set, and ESC Pocket Guidelines; plus previous versions. August,

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heart failure for non-diabetic women with no risk factors is 0.4%, the annual incidence rate for diabetic women with elevated body mass index (BMI) and depressed creatinine clearance was 7% and 13%, respectively.

5447:"How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)" 1343:, named HFA-PEFF. HFA-PEFF considers symptoms and signs, typical clinical demographics (obesity, hypertension, diabetes, elderly, atrial fibrillation), and diagnostic laboratory tests, ECG, and echocardiography. 10244: 10209: 10186: 2469:

and discussed his or her wishes with this individual. A 2016 and 2017 review found that palliative care is associated with improved outcomes, such as quality of life, symptom burden, and satisfaction with care.

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are used for heart failure with reduced ejection fraction as they have demonstrated benefits in reducing hospitalizations and mortality, regardless of whether an individual has comorbid Type 2 Diabetes or not.

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Bestetti RB, Cardinalli-Neto A, Couto LB (April 2020). "The history of the evolution of the knowledge about the diagnosis and the pathogenetic aspects of heart failure: From the Egyptians to James Mackenzie".

552:). Failure of the left side of the heart causes blood to back up into the lungs, causing breathing difficulties and fatigue due to an insufficient supply of oxygenated blood. Common respiratory signs include 5891:

Tower-Rader A, Mohananey D, To A, Lever HM, Popovic ZB, Desai MY (October 2019). "Prognostic Value of Global Longitudinal Strain in Hypertrophic Cardiomyopathy: A Systematic Review of Existing Literature".

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Torio CM, Andrews RM. National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2011. HCUP Statistical Brief #160. Agency for Healthcare Research and Quality, Rockville, MD. August 2013.

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In 2011, nonhypertensive heart failure was one of the 10 most expensive conditions seen during inpatient hospitalizations in the U.S., with aggregate inpatient hospital costs more than $ 10.5 billion.

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connected jugular vein distention with right ventricular failure in 1728. Dropsy attributable to other causes, e.g. kidney failure, was differentiated in the 19th century. The stethoscope, invented by

1796:), which is placed directly in the blood vessel. X-ray images are called angiograms. Heart failure may be the result of coronary artery disease, and its prognosis depends in part on the ability of the 7389: 352:

may be useful to determine the underlying cause. Treatment depends on severity and case. For people with chronic, stable, mild heart failure, treatment usually consists of lifestyle changes, such as

800:) can similarly contribute to the development of heart failure. Genetic predisposition plays an important role. If more than one cause is present, progression is more likely and prognosis is worse. 6483: 4932: 618:, also occurs. It can be measured by the number of pillows required to lie comfortably, with extreme cases of orthopnea forcing the patient to sleep sitting up. Another symptom of heart failure is 3331:"Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015" 2588:

In tropical countries, the most common cause of heart failure is valvular heart disease or some type of cardiomyopathy. As underdeveloped countries have become more affluent, the incidences of

1228:. In heart failure, this mechanism fails, as the ventricle is loaded with blood to the point where heart muscle contraction becomes less efficient. This is due to reduced ability to cross-link 5797:

Somma V, Ha FJ, Palmer S, Mohamed U, Agarwal S (October 2022). "Pacing-induced cardiomyopathy: A systematic review and meta-analysis of definition, prevalence, risk factors, and management".

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The goals of the treatment for people with chronic heart failure are the prolongation of life, prevention of acute decompensation, and reduction of symptoms, allowing for greater activity.

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and consequently to the brain and the remainder of the body's systemic circulation. However, mixed presentations are common and left heart failure is a common cause of right heart failure.

3079:"2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines" 1541: 1523: 1505: 1487: 1373:, or the proportion of blood pumped out of the heart during a single contraction. Ejection fraction is given as a percentage with the normal range being between 50 and 75%. The types are: 5600: 2625:

descent are at a higher risk of heart failure than other ethnic groups. Other sources however have found that rates of heart failure are similar to rates found in other ethnic groups.

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Specifically, in one randomized control trial the patients self-identified as black (defined as of African descent), and in one randomized control trial the patients were defined as

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behaviour change intervention alongside an exercise programme. An intervention is expected to be more efficacious in encouraging physical activity than the usual care if it includes

8015:"2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines" 6913: 866:(a condition of sleep wherein disordered breathing overlaps with obesity, hypertension, and/or diabetes) is regarded as an independent cause of heart failure. Recent reports from 2273:, is an effective alternate strategy. This regimen has been shown to reduce mortality in people with moderate heart failure. It is especially beneficial in the black population. 2850:

Heart failure is associated with a high health expenditure, mostly because of the cost of hospitalizations; costs have been estimated to amount to 2% of the total budget of the

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Heart failure with mildly reduced ejection fraction (HFmrEF), previously called "heart failure with mid-range ejection fraction", is defined by an ejection fraction of 41–49%.

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can occur when there is increased cardiac demand that results in increased left ventricular diastolic pressure which can develop into pulmonary congestion (pulmonary edema).

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treatment strategies exist that can provide a significant improvement in outcomes, including the relief of symptoms, exercise tolerance, and a decrease in the likelihood of

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Girerd N, Seronde MF, Coiro S, Chouihed T, Bilbault P, Braun F, et al. (2018). "Integrative Assessment of Congestion in Heart Failure Throughout the Patient Journey".

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In 2022, heart failure affected about 64 million people globally. Overall, around 2% of adults have heart failure. In those over the age of 75, rates are greater than 10%.

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The degree of coexisting illness: i.e. heart failure/systemic hypertension, heart failure/pulmonary hypertension, heart failure/diabetes, heart failure/kidney failure, etc.

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Witt BJ, Gami AS, Ballman KV, Brown RD, Meverden RA, Jacobsen SJ, et al. (August 2007). "The incidence of ischemic stroke in chronic heart failure: a meta-analysis".

5527: 3850:"New devices in heart failure: a European Heart Rhythm Association report: developed by the European Heart Rhythm Association; endorsed by the Heart Failure Association" 2365:

for the treatment of euvolemic hyponatremia in those with heart failure. In rare cases hypertonic 3% saline together with diuretics may be used to correct hyponatremia.

5082:"Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the Task Force on Acute Heart Failure of the European Society of Cardiology" 8704:

Krumholz HM, Chen YT, Wang Y, Vaccarino V, Radford MJ, Horwitz RI (January 2000). "Predictors of readmission among elderly survivors of admission with heart failure".

7302:"Effect of age and sex on efficacy and tolerability of β blockers in patients with heart failure with reduced ejection fraction: individual patient data meta-analysis" 6025:"Point-of-care ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis" 1615:(proportion of the heart size to the chest). In left ventricular failure, evidence may exist of vascular redistribution (upper lobe blood diversion or cephalization), 700:

failure of the right ventricle leads to congestion of systemic capillaries. This generates excess fluid accumulation in the body. This causes swelling under the skin (

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Heart failure with recovered ejection fraction (HFrecovEF or HFrecEF): patients previously with HFrEF with complete normalization of left ventricular ejection (≥50%).

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Bibbins-Domingo, K., Lin, F., & Vittinghoff, E. (2005). Predictors of heart failure among women with coronary disease. ACC Current Journal Review, 14(2), 35–36.

2288:, in addition to beta blockers and ACE-I, can improve symptoms and reduce mortality in people with symptomatic heart failure with reduced ejection fraction (HFrEF). 6504:

Thom, T., Haase, N., Rosamond, W., Howard, V., Rumsfeld, J., & Manolio, T. et al. (2006). Heart Disease and Stroke Statistics—2006 Update. Circulation, 113(6).

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70 beats per minute. Ivabradine has been found to reduce the risk of hospitalization for heart failure exacerbations in this subgroup of people with heart failure.

1479:. Echocardiography can also help determine if acute myocardial ischemia is the precipitating cause, and may manifest as regional wall motion abnormalities on echo. 2136:

to walk or exercise, like a phone call or a text message. It is extremely helpful if a trusted clinician provides explicit advice to engage in physical activity (

4359: 3130:(ed.). "Secondhand Smoke Exposure is Associated with Prevalent Heart Failure: Longitudinal Examination of the National Health and Nutrition Examination Survey". 8942: 7943: 6527: 9813:

Stewart S, Jenkins A, Buchan S, McGuire A, Capewell S, McMurray JJ (June 2002). "The current cost of heart failure to the National Health Service in the UK".

2452:, which have commonly been used as a bridge to heart transplantation, but have been used more recently as a destination treatment for advanced heart failure. 1963:

Treatment focuses on improving the symptoms and preventing the progression of the disease. Reversible causes of heart failure also need to be addressed (e.g.

11013: 7350: 7281: 6751:"Intrathoracic impedance monitoring in patients with heart failure: correlation with fluid status and feasibility of early warning preceding hospitalization" 2140:). Another highly effective strategy is to place objects that will serve as a cue to engage in physical activity in the everyday environment of the patient ( 4329: 3274: 1394:

Heart failure may also be classified as acute or chronic. Chronic heart failure is a long-term condition, usually kept stable by the treatment of symptoms.

6453: 5141:"Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials" 4431: 2144:; e.g., exercise step or treadmill). Encouragement to walk or exercise in various settings beyond CR (e.g., home, neighbourhood, parks) is also promising ( 2024:

Heart failure can result from a variety of conditions. In considering therapeutic options, excluding reversible causes is of primary importance, including

1825: 2123:

has been shown to be an effective intervention to relieve thirst in patients experiencing heart failure, although patient acceptability remains an issue.

9858:"Heart disease and stroke statistics – 2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee" 6475: 5502: 3472: 8419:"Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables" 1693: 1267: 6543:

Cebeci F, Arikan B, Catal E, Bayezid O (2021). "A bridge to transplantation: The life experiences of patients with a left ventricular assist device".

1685:). Although these findings are not specific to the diagnosis of heart failure, a normal ECG virtually excludes left ventricular systolic dysfunction. 1471:(the connective tissue sac surrounding the heart). Echocardiography may also aid in deciding specific treatments, such as medication, insertion of an 505:

is insufficient to meet the needs of the body and lungs. The term "congestive heart failure" is often used because one of the most common symptoms is

309:. These cause heart failure by altering the structure or the function of the heart or in some cases both. There are different types of heart failure: 6607:"Building consensus for provision of breathlessness rehabilitation for patients with chronic obstructive pulmonary disease and chronic heart failure" 6210: 1697: 1263: 1120:

95% CI: 1.1, 1.33). The pooled incidence of heart failure in breast cancer survivors was 4.44 (95% CI 3.33-5.92) per 1000 person-years of follow-up.

5231:"Comprehensive comparative effectiveness and safety of first-line antihypertensive drug classes: a systematic, multinational, large-scale analysis" 1849:

Stage C: Previous or current symptoms of heart failure in the context of an underlying structural heart problem, but managed with medical treatment

9951:"Discrepancies in autologous bone marrow stem cell trials and enhancement of ejection fraction (DAMASCENE): weighted regression and meta-analysis" 8094: 4051: 4195: 2613:), they are more likely than men to have diastolic dysfunction, and seem to experience a lower overall quality of life than men after diagnosis. 2172:

and reduce the risk of hospital admission for worsening symptoms, but no evidence shows a reduction in mortality rates as a result of exercise.

1824:

Heart failure is commonly stratified by the degree of functional impairment conferred by the severity of the heart failure, as reflected in the

8346:

Auble TE, Hsieh M, McCausland JB, Yealy DM (August 2007). "Comparison of four clinical prediction rules for estimating risk in heart failure".

6508: 4299: 2013:

is indicated in those with oxygen saturation levels below 90%, but is not recommended in those with normal oxygen levels in normal atmosphere.

1384: 1340: 1311: 1252: 330: 9175: 5114: 2525:

max less than 12–14 cc/kg/min indicates poor survival and suggests that the person may be a candidate for a heart transplant. People with a VO

1557: 388:

may also be prescribed to prevent fluid retention and the resulting shortness of breath. Depending on the case, an implanted device such as a

6279:"Limitations of the New York Heart Association functional classification system and self-reported walking distances in chronic heart failure" 2098:(which in the shorter term reflects fluid shifts). Remote monitoring can be effective to reduce complications for people with heart failure. 5476: 3143: 2728:

The 19th century also saw experimental and conceptual advances in the physiology of heart contraction, which led to the formulation of the

7553: 2952: 2798:

Use of organic mercury compounds as diuretics, beyond their role in syphilis treatment, started in 1920, though it was limited by their

10654: 9791: 7970:

for "Evaluate Safety and Efficacy of the OPTIMIZER System in Subjects With Moderate-to-Severe Heart Failure: FIX-HF-5C (FIX-HF-5C)" at

4090: 17: 8797: 4883:"Association Between Visit-to-Visit Blood Pressure Variability in Early Adulthood and Myocardial Structure and Function in Later Life" 2670:, and the current concept of heart failure had not developed yet. Although shortage of breath had been connected to heart disease by 2534:

slope > 35 from the CPX test. The heart failure survival score is calculated using a combination of clinical predictors and the VO

2006: 8640: 7287:

Clinical guideline 108: Chronic heart failure – managements (ARBs) of chronic heart failure in adults in primary and secondary care

4683:"Prognostic Relevance of Gene-Environment Interactions in Patients With Dilated Cardiomyopathy: Applying the MOGE(S) Classification" 10344: 10157: 6095:. National Institute for Health and Care Excellence: Guidelines. London: National Institute for Health and Care Excellence (NICE). 4724:"Obstructive Sleep Apnea in Heart Failure: Review of Prevalence, Treatment with Continuous Positive Airway Pressure, and Prognosis" 3679:. National Institute for Health and Care Excellence: Guidelines. London: National Institute for Health and Care Excellence (NICE). 3632:. National Institute for Health and Care Excellence: Guidelines. London: National Institute for Health and Care Excellence (NICE). 3555:. National Institute for Health and Care Excellence: Guidelines. London: National Institute for Health and Care Excellence (NICE). 3013:. National Institute for Health and Care Excellence: Guidelines. London: National Institute for Health and Care Excellence (NICE). 8903: 6654:

Zhou X, Xu W, Xu Y, Qian Z (August 2019). "Iron Supplementation Improves Cardiovascular Outcomes in Patients with Heart Failure".

2974: 11439: 10109: 7983: 361: 325:, and biventricular heart failure, which affects both sides of the heart. Left-sided heart failure may be present with a reduced 11071: 10388: 4775:"Visit-to-Visit Variability of Blood Pressure and Coronary Heart Disease, Stroke, Heart Failure, and Mortality: A Cohort Study" 4500: 2886:. Currently, an increasing body of research is directed at understanding the role of perturbations of epigenetic processes in 1472: 708:) and usually affects the dependent parts of the body first, causing foot and ankle swelling in people who are standing up and 622:: a sudden nocturnal attack of severe shortness of breath, usually occurring several hours after falling asleep. There may be " 5519: 1409:

Several terms are closely related to heart failure and may be the cause of heart failure, but should not be confused with it.

806:

can predispose a person to develop heart failure later in life and has many causes including systemic viral infections (e.g.,

9079: 8688: 8663: 8634: 7263: 6842: 6381: 6240: 6100: 6073: 5426: 4585: 4473: 4084: 3776:

Chronic Heart Failure: National Clinical Guideline for Diagnosis and Management in Primary and Secondary Care: Partial Update

3684: 3637: 3600:

Chronic Heart Failure: National Clinical Guideline for Diagnosis and Management in Primary and Secondary Care: Partial Update

3560: 3530: 3504: 3443:

Chronic heart failure: National clinical guideline for diagnosis and management in primary and secondary care: Partial update

3305:

Chronic Heart Failure: National Clinical Guideline for Diagnosis and Management in Primary and Secondary Care: Partial Update

3018: 2946: 2244: 2065: 377: 2247:. Use of the combination agent ARNI requires the cessation of ACE-I or ARB therapy at least 36 hours before its initiation. 10875: 10712: 4937: 4269: 4230: 982: 981:

Other factors that may worsen CHF include: anemia, hyperthyroidism, excessive fluid or salt intake, and medication such as

10154:. JACC article link, quick references, slides, perspectives, education, apps and tools, and patient resources. April, 2022 7579: 7487: 7351:"Efficacy of β blockers in patients with heart failure plus atrial fibrillation: an individual-patient data meta-analysis" 6114: 6001: 3698: 3651: 3574: 3032: 2311:

Diuretics have been a mainstay of treatment against symptoms of fluid accumulation, and include diuretics classes such as

1633: 1205:. Over time, these increases in workload, which are mediated by long-term activation of neurohormonal systems such as the 11522: 11066: 10880: 10870: 10459: 1993:, the immediate goal is to re-establish adequate perfusion and oxygen delivery to end organs. This entails ensuring that 1221: 1026: 998: 9630: 8872: 8679:

McMurray JJ, Pfeffer MA (2011). "Chapter 59: Heart Failure: Management and Diagnosis". In Goldman L, Schafer AI (eds.).

11543: 11177: 11008: 10622: 6700:

Nishikawa Y, Hiroyama N, Fukahori H, Ota E, Mizuno A, Miyashita M, et al. (Cochrane Heart Group) (February 2020).

2168:. The inclusion of regular physical conditioning as part of a cardiac rehabilitation program can significantly improve 1809: 881:

happens when the amount of blood pumped out is more than typical and the heart is unable to keep up. This can occur in

870:

have also linked variation in blood pressure to heart failure and cardiac changes that may give rise to heart failure.

796:

of an unknown cause. In addition, viral infection and subsequent inflammation of the heart's myocardial tissue (termed

8926: 7205:"Four pillars of heart failure: contemporary pharmacological therapy for heart failure with reduced ejection fraction" 4351: 1573: 1172:. Yohimbine can exacerbate heart failure by increasing blood pressure through alpha-2 adrenergic receptor antagonism. 11048: 7935: 2437: 1990: 1984: 1476: 1395: 1100:, NSAIDs may exacerbate heart failure through several mechanisms, including promotion of fluid retention, increasing 934: 397: 393: 5762:

Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation".

2743:

One of the earliest treatments of heart failure, relief of swelling by bloodletting with various methods, including

591:(additional heart sounds), which may be heard as a sign of increased blood flow or increased intracardiac pressure. 254:

and also measured by the severity of symptoms. Other conditions that have symptoms similar to heart failure include

11558: 11043: 10151: 2400: 2222:

is recommended as first choice of RAS inhibitors in American guidelines published by AHA/ACC in 2022. Use of ], or

1597: 1458:(EDV, the total amount of blood at the end of diastole), and the SV in proportion to the EDV, a value known as the 1323: 1291: 1181: 401: 2436:

the heart and carry depolarizing impulses to the left ventricle). Using a special pacing algorithm, biventricular

2073:

appears to reduce hospitalization but not all-cause mortality in patients with iron deficiency and heart failure.

10912: 10693: 5338:

Lenneman CG, Sawyer DB (March 2016). "Cardio-Oncology: An Update on Cardiotoxicity of Cancer-Related Treatment".

4321: 3241: 2633:

For centuries, the disease entity which would include many cases of what today would be called heart failure was

2354: 2257:

provided by ACE-I/ARB. The mortality benefits of beta blockers in people with systolic dysfunction who also have

6445: 4382: 10988: 10983: 10907: 10161: 10143: 8654:

Massie BM (2011). "Chapter 58: Heart Failure: Pathophysiology and Diagnosis". In Goldman L, Schafer AI (eds.).

8299:"Association Between Palliative Care and Patient and Caregiver Outcomes: A Systematic Review and Meta-analysis" 2394: 2340: 1832: 1813: 1336: 1319: 1306: 1287: 1279: 642:, and cool extremities at rest. Loss of consciousness may also occur due to loss of blood supply to the brain. 5551:"Updated ACC/AHA/HFSA 2022 guidelines on heart failure: what is new? From epidemiology to clinical management" 5299:"Drugs That May Cause or Exacerbate Heart Failure: A Scientific Statement From the American Heart Association" 2265:

In people who are intolerant of ACE-I and ARB or who have significant kidney dysfunction, the use of combined

11334: 11210: 11139: 10971: 10707: 7484:

Chronic Heart Failure: National Clinical Guideline for Diagnosis and Management in Primary and Secondary Care

5498: 3464: 2815:

were added to available treatments of fluid retention, while a patient with heart failure received the first

2390: 1674: 1600:. Yet, no obvious lung edema is seen. Overall, this indicates intermediate severity (stage II) heart failure. 10199: 8963:"Temporal trends and patterns in heart failure incidence: a population-based study of 4 million individuals" 2799: 2465:

care planning, goals of care in the case of a significant decline, and making sure the person has a medical

2175:

Home visits and regular monitoring at heart-failure clinics reduce the need for hospitalization and improve

1882:

or high cardiac output with low vascular resistance (low-output heart failure vs. high-output heart failure)

1843:

Stage A: People at high risk for developing HF in the future, but no functional or structural heart disorder

1201:

Heart failure is caused by any condition that reduces the efficiency of the heart muscle, through damage or

11329: 11122: 11105: 11038: 10958: 10337: 8119:

Carrel T, Englberger L, Martinelli MV, Takala J, Boesch C, Sigurdadottir V, et al. (18 October 2012).

2667: 2420: 2362: 2328: 2277: 2236: 2215: 1879: 1705: 1678: 1216:

The heart of a person with heart failure may have a reduced force of contraction due to overloading of the

1206: 1101: 859: 619: 389: 6188: 5634:"2021 ESC Clinical Practice Guidelines for the diagnosis and treatment of acute and chronic heart failure" 2823:. Over the following decades, new drug classes found their place in heart failure therapeutics, including 1891: 462: 11432: 11172: 10617: 8297:

Kavalieratos D, Corbelli J, Zhang D, Dionne-Odom JN, Ernecoff NC, Hanmer J, et al. (November 2016).

2887: 2090:

The various measures often used to assess the progress of people being treated for heart failure include

1958: 1914: 1427: 962:(fail to meet the body's metabolic needs). This most commonly results from a concurrent illness (such as 10310: 7051:"Efficacy of interventions to increase physical activity for people with heart failure: a meta-analysis" 6994:"Efficacy of interventions to increase physical activity for people with heart failure: a meta-analysis" 4681:

Hazebroek MR, Moors S, Dennert R, van den Wijngaard A, Krapels I, Hoos M, et al. (September 2015).

2674:

round 1000 CE, decisive for modern understanding of the nature of the condition were the description of

1696:

is the favoured biomarker for the diagnosis of heart failure, according to guidelines published 2018 by

1450:

of the heart) is commonly used to support a clinical diagnosis of heart failure. This can determine the

11154: 10642: 10627: 10147: 8162:"Drug therapy in the heart transplant recipient: part I: cardiac rejection and immunosuppressive drugs" 8055: 6917: 4043: 2784: 2324: 2120: 1998: 1941: 1836: 1399: 1315: 1283: 922: 910: 404:

may be beneficial. In severe disease that persists despite all other measures, a cardiac assist device

10701: 8204:

Kavalieratos D, Gelfman LP, Tycon LE, Riegel B, Bekelman DB, Ikejiani DZ, et al. (October 2017).

4191: 2351:

noncompaction, familial dilated cardiomyopathy, or a thromboembolic event in a first-degree relative.

1220:. In a normal heart, increased filling of the ventricle results in increased contraction force by the 614:

on exertion and, in severe cases, dyspnea at rest. Increasing breathlessness while lying down, called

11232: 10929: 10897: 10824: 10551: 7851:"Clinical effects of cardiac contractility modulation (CCM) as a treatment for chronic heart failure" 7646:"The impact of anemia on the prognosis of chronic heart failure: a meta-analysis and systemic review" 4773:

Muntner P, Whittle J, Lynch AI, Colantonio LD, Simpson LM, Einhorn PT, et al. (September 2015).

4525: 2883: 2733: 2698: 2449: 2416: 2415:

and the heart's pumping capacity. The CCM mechanism is based on stimulation of the cardiac muscle by

1403: 878: 855: 405: 360:, and dietary changes, as well as medications. In heart failure due to left ventricular dysfunction, 310: 68: 10118:– patient information website of the Heart Failure Association of the European Society of Cardiology 9949:

Nowbar AN, Mielewczik M, Karavassilis M, Dehbi HM, Shun-Shin MJ, Jones S, et al. (April 2014).

5935:

Sirajuddin A, Mirmomen SM, Kligerman SJ, Groves DW, Burke AP, Kureshi F, et al. (1 July 2021).

4291: 2748: 1213:, dilation, and structural changes in the shape of the left ventricle from elliptical to spherical. 11356: 11182: 11112: 10902: 10799: 10780: 10610: 10383: 10259: 10112:, American Heart Association – information and resources for treating and living with heart failure 9538:

Ventura HO, Mehra MR (May 2005). "Bloodletting as a cure for dropsy: heart failure down the ages".

6935:

Mahtani KR, Heneghan C, Onakpoya I, Tierney S, Aronson JK, Roberts N, et al. (November 2018).

5714:"Heart failure with recovered ejection fraction and the utility of defibrillator therapy: a review" 5663:

Bozkurt B, Hershberger RE, Butler J, Grady KL, Heidenreich PA, Isler ML, et al. (April 2021).

5081: 2832: 2744: 2488: 2106:

Behavior modification is a primary consideration in chronic heart failure management program, with

1937: 1896: 1805: 1682: 1054: 318: 3328: 1607:

are frequently used to aid in the diagnosis of CHF. In a person who is compensated, this may show

544:

The left side of the heart takes oxygen-rich blood from the lungs and pumps it to the rest of the

11548: 11389: 11363: 11351: 11339: 11324: 11058: 11000: 10804: 10785: 10437: 10377: 10330: 8821:"Heart disease and stroke statistics – 2013 update: a report from the American Heart Association" 6406:"Dose-Response Relationship Between Physical Activity and Risk of Heart Failure: A Meta-Analysis" 5080:

Nieminen MS, Böhm M, Cowie MR, Drexler H, Filippatos GS, Jondeau G, et al. (February 2005).

4456:

Alcantara CA, Chandra A, Morvey D, von Schwarz ER (3 January 2018). "Acute Right Heart Failure".

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and arrhythmias). Heart failure is the leading cause of hospitalization in people older than 65.

2501: 2382: 1766: 1190:

Model of a normal heart (left); and a weakened heart, with over-stretched muscle and dilation of

1074: 863: 765: 683: 659: 278: 8417:

Juenger J, Schellberg D, Kraemer S, Haunstetter A, Zugck C, Herzog W, et al. (March 2002).

6329:

Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al. (September 2005).

5446: 4950:

McCulloch B (December 2015). "High-Output Heart Failure Caused by Thyrotoxicosis and Beriberi".

3996:"Heart disease and stroke statistics--2012 update: a report from the American Heart Association" 2327:. Although widely used, evidence on their efficacy and safety is limited, with the exception of 509:

or fluid accumulation in the tissues and veins of the lungs or other parts of a person's body.

457:

at rest or during activity. It develops when the heart fails to properly fill with blood during

238:

Although symptoms vary based on which side of the heart is affected, HF typically presents with

11553: 11499: 11425: 10978: 10944: 10887: 10865: 10687: 10669: 10605: 10472: 10425: 10353: 8582:"Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association" 8160:

Lindenfeld J, Miller GG, Shakar SF, Zolty R, Lowes BD, Wolfel EE, et al. (December 2004).

6277:

Raphael C, Briscoe C, Davies J, Ian Whinnett Z, Manisty C, Sutton R, et al. (April 2007).

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Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. (January 2012).

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National Guideline Centre (UK) (September 2018). "7. Rehabilitation in chronic heart failure".

3494: 2795:

in 1877 was another method of removing excess fluid by directly inserting into swollen limbs.

2702: 2320: 1670: 1423: 1169: 827: 811: 781: 717: 667: 294: 165: 10299: 10203: 10195: 8961:

Conrad N, Judge A, Tran J, Mohseni H, Hedgecott D, Crespillo AP, et al. (February 2018).

8819:

Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. (January 2013).

7545: 6476:"2019 Updated Cardiovascular Disease Prevention Guidelines Announced - Johns Hopkins Medicine" 6371: 5712:

Devgun JK, Kennedy S, Slivnick J, Garrett Z, Dodd K, Derbala MH, et al. (February 2022).

4881:

Nwabuo CC, Yano Y, Moreira HT, Appiah D, Vasconcellos HD, Aghaji QN, et al. (July 2020).

1298:

if positive. This is recommended in those with symptoms consistent with heart failure such as

10742: 10737: 10632: 10547: 10442: 8054:

Ruschitzka F, Abraham WT, Singh JP, Bax JJ, Borer JS, Brugada J, et al. (October 2013).

7416:"Effects of beta-blockers on heart failure with preserved ejection fraction: a meta-analysis" 6843:"Structured telephone support or non-invasive telemonitoring for patients with heart failure" 4381:

Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. (14 July 2016).

4241:– via National Center for Biotechnology Information, U.S. National Library of Medicine. 3802:

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3520: 3499:. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. 2014. p. 1124. 3240:

McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. (September 2021).

2936: 2675: 2203:

is the standard of care as of 2021 for heart failure with reduced ejection fraction (HFrEF).

2196: 2049: 1739: 1620: 1113: 963: 918: 769: 733: 663: 549: 409: 135: 131: 123: 72: 8789: 8121:"Continuous flow left ventricular assist devices: a valid option for heart failure patients" 7601:

von Lueder TG, Atar D, Krum H (October 2013). "Diuretic use in heart failure and outcomes".

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Kotecha D, Holmes J, Krum H, Altman DG, Manzano L, Cleland JG, et al. (December 2014).

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Kuck KH, Bordachar P, Borggrefe M, Boriani G, Burri H, Leyva F, et al. (January 2014).

3077:

Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. (May 2022).

1997:

are adequate. Immediate treatments usually involve some combination of vasodilators such as

1132:

carry a risk of exacerbating existing heart failure, and are not recommended. This includes

950:

of acute cardiac decompensation. The short, horizontal lines can be found everywhere in the

11238: 10766: 10747: 10647: 10558: 10501: 9097:"Heart failure across Asia: Same healthcare burden but differences in organization of care" 9095:

Reyes EB, Ha JW, Firdaus I, Ghazi AM, Phrommintikul A, Sim D, et al. (November 2016).

8013:

Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, et al. (October 2013).

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Pieske B, Tschöpe C, de Boer RA, Fraser AG, Anker SD, Donal E, et al. (October 2019).

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Galimzhanov A, Istanbuly S, Tun HN, Ozbay B, Alasnag M, Ky B, et al. (December 2023).

5188:

Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. (2018).

2411:

systolic heart failure (NYHA class II–IV), which enhances both the strength of ventricular

2386: 2270: 2228: 2219: 2188: 2070: 2037: 1930: 1868: 1743: 1735: 1612: 1589: 1455: 1248: 1129: 1058: 1018: 785: 687: 600: 369: 298: 10001:

Papait R, Serio S, Condorelli G (October 2020). "Role of the Epigenome in Heart Failure".

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Man WD, Chowdhury F, Taylor RS, Evans RA, Doherty P, Singh SJ, et al. (August 2016).

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2423:-like device. CCM is particularly suitable for the treatment of heart failure with normal 1627:, and interstitial edema. Ultrasound of the lung may also be able to detect Kerley lines. 1116:, thus are not recommended in people with heart failure with a reduced ejection fraction. 8: 11494: 11477: 11467: 11243: 11100: 11095: 11018: 10922: 10892: 10851: 10477: 10394: 10248: 10041:"The roles and mechanisms of epigenetic regulation in pathological myocardial remodeling" 8622: 7936:"Der Besondere Stellenwert der Kardialen Kontraktilitätsmodulation in der Devicetherapie" 7723:

Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Colvin MM, et al. (August 2017).

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Harrison's principles of internal medicine: Chapter 234. Heart Failure and Cor Pulmonale

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Sayer G, Semigran MJ (22 February 2017). "Acute and Chronic Right Ventricular Failure".

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is frequently assessed as a marker of fluid status, which can be accentuated by testing

477:. Impaired ejection can lead to inadequate blood flow to the body tissues, resulting in 11346: 11144: 10966: 10917: 10542: 10489: 10399: 10067: 10040: 9975: 9950: 9926: 9901: 9856:

Rosamond W, Flegal K, Furie K, Go A, Greenlund K, Haase N, et al. (January 2008).

9838: 9762: 9737: 9718: 9512: 9487: 9390: 9373: 9354: 9302: 9275: 9227: 9044: 8987: 8962: 8845: 8820: 8765: 8740: 8527: 8443: 8418: 8323: 8298: 8230: 8205: 8178: 8161: 8086: 7971: 7880: 7790: 7765: 7626: 7450: 7415: 7381: 7326: 7301: 7300:

Kotecha D, Manzano L, Krum H, Rosano G, Holmes J, Altman DG, et al. (April 2016).

7231: 7204: 7185: 7136: 7077: 7050: 7026: 6993: 6974: 6961: 6936: 6878: 6818: 6791: 6726: 6701: 6679: 6631: 6606: 6568: 6303: 6278: 6162: 5961: 5936: 5917: 5868: 5841: 5822: 5738: 5713: 5689: 5664: 5577: 5550: 5255: 5230: 5165: 5140: 5062: 5013: 4986: 4907: 4882: 4858: 4823: 4799: 4774: 4750: 4723: 4658: 4633: 4596: 4538: 4484: 4423: 4020: 3995: 3971: 3946: 3927: 3406: 3355: 3330: 3179: 3155: 3108: 2820: 2768: 2729: 2683: 2412: 2254: 2107: 1789: 1747: 1153: 971: 831: 569: 545: 498: 454: 450: 92: 10253: 10158:

2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

9874: 9857: 9826: 9031: 9014: 8978: 8717: 8359: 8274: 8257: 7523: 7369: 6767: 6750: 6422: 6405: 6347: 6330: 5775: 5246: 5156: 3915: 3723:

Molloy C, Long L, Mordi IR, Bridges C, Sagar VA, Davies EJ, et al. (March 2024).

3394: 3346: 2714: 2504:

at least 115 mm Hg have less than 10% chance of inpatient death or complications.

1895:

Siderophages (one indicated by white arrow) and pulmonary congestion, indicating left

11448: 11406: 11257: 11215: 11130: 10948: 10846: 10563: 10506: 10404: 10270: 10072: 10018: 9980: 9931: 9879: 9830: 9767: 9722: 9710: 9675: 9670: 9653: 9596: 9555: 9517: 9468: 9422: 9395: 9358: 9346: 9307: 9253: 9219: 9167: 9128: 9075: 9036: 8992: 8934: 8897:

HCUP Statistical Brief #153. Agency for Healthcare Research and Quality. April 2013.

8850: 8770: 8721: 8684: 8659: 8630: 8603: 8562: 8519: 8484: 8448: 8399: 8363: 8328: 8279: 8235: 8183: 8142: 8090: 8078: 8036: 7916: 7872: 7831: 7795: 7746: 7667: 7662: 7645: 7618: 7527: 7455: 7373: 7331: 7259: 7236: 7189: 7177: 7140: 7128: 7082: 7031: 7013: 6966: 6883: 6823: 6792:"Remote Monitoring of Patients With Heart Failure: An Overview of Systematic Reviews" 6772: 6731: 6671: 6636: 6572: 6560: 6427: 6377: 6352: 6308: 6154: 6150: 6106: 6096: 6069: 6046: 5966: 5909: 5873: 5826: 5814: 5779: 5743: 5694: 5582: 5468: 5422: 5399: 5355: 5320: 5260: 5211: 5170: 5106: 5054: 5018: 4967: 4912: 4863: 4804: 4755: 4704: 4663: 4581: 4530: 4469: 4427: 4415: 4261: 4173: 4129: 4080: 4025: 3976: 3919: 3871: 3825: 3779: 3754: 3690: 3680: 3643: 3633: 3603: 3566: 3556: 3526: 3500: 3446: 3398: 3360: 3308: 3266: 3183: 3171: 3163: 3112: 3100: 3024: 3014: 2942: 2863: 2764: 2756: 2659: 2652: 2478:, according to American College of Cardiology/American Heart Association guidelines. 2466: 2053: 1926: 1662: 1459: 1454:(SV, the amount of blood in the heart that exits the ventricles with each beat), the 1370: 1217: 986: 691: 671: 506: 474: 357: 353: 349: 326: 251: 243: 153: 101: 80: 10139: 9902:"Stem cell therapy for chronic ischaemic heart disease and congestive heart failure" 9842: 9048: 7884: 7385: 6978: 6952: 6683: 6505: 6166: 5921: 5066: 3962: 3945:

Retrum JH, Boggs J, Hersh A, Wright L, Main DS, Magid DJ, et al. (March 2013).

3931: 3410: 736:

and reduced breath sounds at the base of the lungs may suggest the development of a

11379: 11271: 11164: 10860: 10062: 10052: 10010: 9970: 9962: 9921: 9917: 9913: 9869: 9822: 9757: 9749: 9702: 9665: 9586: 9551: 9547: 9507: 9499: 9458: 9385: 9338: 9297: 9287: 9231: 9211: 9163: 9159: 9118: 9108: 9067: 9026: 8982: 8974: 8840: 8832: 8760: 8752: 8713: 8593: 8558: 8554: 8531: 8511: 8476: 8438: 8430: 8391: 8355: 8318: 8310: 8269: 8225: 8217: 8206:"Palliative Care in Heart Failure: Rationale, Evidence, and Future Priorities" 8173: 8132: 8070: 8026: 7908: 7862: 7823: 7785: 7777: 7736: 7657: 7630: 7610: 7519: 7445: 7435: 7365: 7321: 7313: 7226: 7218: 7167: 7118: 7110: 7072: 7062: 7021: 7005: 6956: 6948: 6873: 6865: 6861: 6857: 6813: 6803: 6762: 6721: 6717: 6713: 6663: 6626: 6618: 6552: 6417: 6342: 6298: 6290: 6200: 6146: 6036: 5956: 5948: 5901: 5863: 5853: 5806: 5771: 5733: 5725: 5684: 5676: 5572: 5562: 5458: 5389: 5347: 5310: 5250: 5242: 5229:

Suchard MA, Schuemie MJ, Krumholz HM, You SC, Chen R, Pratt N, et al. (2019).

5201: 5160: 5152: 5096: 5046: 5008: 4998: 4959: 4902: 4894: 4853: 4843: 4835: 4794: 4786: 4745: 4735: 4694: 4653: 4645: 4591: 4573: 4542: 4520: 4512: 4479: 4461: 4407: 4397: 4163: 4121: 4015: 4007: 3966: 3958: 3911: 3861: 3815: 3744: 3740: 3736: 3390: 3350: 3342: 3329:

GBD 2015 Disease and Injury Incidence and Prevalence Collaborators (October 2016).

3256: 3147: 3090: 2816: 2792: 2722: 1972: 1852:

Stage D: Advanced disease requiring hospital-based support, a heart transplant, or

1593: 1577: 1295: 1271: 1066: 914: 819: 737: 701: 517: 341: 247: 8927:"Conditions With the Largest Number of Adult Hospital Readmissions by Payer, 2011" 7966: 6524: 6232: 5351: 5297:

Page RL, O'Bryant CL, Cheng D, Dow TJ, Ky B, Stein CM, et al. (August 2016).

11401: 10793: 10774: 10761: 10568: 10447: 10322: 10264: 10101: 9342: 9113: 9096: 9071: 8836: 8598: 8581: 8395: 8031: 8014: 7912: 7827: 7741: 7724: 7440: 6667: 6556: 6531: 6512: 5840:

Mages C, Gampp H, Syren P, Rahm AK, André F, Frey N, et al. (October 2021).

5680: 5315: 5298: 4898: 4465: 4011: 3820: 3803: 2879: 2871: 2737: 2647: 2344: 2291: 2200: 2176: 2169: 2115: 2082:

preferences and values. The findings are however, based on low-quality evidence.

2061: 2025: 1853: 1797: 1731: 1419: 1202: 1050: 1002: 902: 882: 839: 596: 565: 521: 381: 271: 7222: 7067: 7009: 6264:

Diseases of the heart and blood vessels. Nomenclature and criteria for diagnosis

6089:

National Guideline Centre (UK) (September 2018). "5. Diagnosing heart failure".

5810: 4722:

Khattak HK, Hayat F, Pamboukian SV, Hahn HS, Schwartz BP, Stein PK (June 2018).

4577: 4229:. Institute for Quality and Efficiency in Health Care (IQWiG). 25 January 2018. 4224: 3261: 2706: 337:, in which blood flow stops completely due to the failure of the heart to pump. 11506: 11489: 11394: 11302: 11200: 11192: 11090: 10600: 10593: 10580: 10275: 10014: 9215: 8221: 7575: 7479: 7172: 7155: 6090: 5993: 5905: 5463: 5206: 5189: 5101: 5050: 4699: 4682: 4402: 4253: 4168: 4151: 4125: 3674: 3627: 3550: 3095: 3078: 3008: 2812: 2687: 2332: 2281: 2111: 2057: 2010: 1994: 1968: 1902: 1762: 1709: 1701: 1443: 1410: 1225: 1191: 959: 943: 867: 803: 793: 741: 694:

which causes the compensatory increase in contraction strength may be present.

623: 529: 502: 334: 306: 259: 158: 31: 10238: 10234: 10230: 10226: 10222: 9706: 9622: 9503: 8756: 8056:"Cardiac-resynchronization therapy in heart failure with a narrow QRS complex" 7781: 7017: 6261: 4963: 3866: 3849: 3626:

National Guideline Centre (UK) (September 2018). "6. Treating heart failure".

2389:

is high enough to warrant AICD placement. Its use is therefore recommended in

1351: 978:, or a person's failure to maintain a fluid restriction, diet, or medication. 595:

may indicate the presence of valvular heart disease, either as a cause (e.g.,

11537: 11472: 11295: 10430: 10057: 8868: 6749:

Yu CM, Wang L, Chau E, Chan RH, Kong SL, Tang MO, et al. (August 2005).

6622: 6205: 5567: 5394: 5377: 4824:"Blood Pressure Variability and Risk of Heart Failure in ACCORD and the VADT" 3159: 3127: 2836: 2780: 2767:, including digoxin, still used today in the treatment of heart failure. The 2312: 2250: 2232: 2091: 1925:

A person's risk of developing heart failure is inversely related to level of

1451: 1097: 1070: 1062: 885:

situations such as blood or serum infusions, kidney diseases, chronic severe

588: 434: 430: 373: 263: 229: 10218: 10128: 9753: 9591: 9574: 9463: 9447:"The evolution of our knowledge about the heart and its diseases since 1628" 9446: 8314: 7867: 7850: 6841:

Inglis SC, Clark RA, Dierckx R, Prieto-Merino D, Cleland JG (October 2015).

6294: 5003: 4987:"High Output Heart Failure in Multiple Myeloma: Pathogenetic Considerations" 4649: 2693:

The role of the heart in fluid retention began to be better appreciated, as

11316: 11290: 11134: 11082: 10755: 10731: 10678: 10537: 10076: 10022: 9984: 9935: 9900:

Fisher SA, Doree C, Mathur A, Taggart DP, Martin-Rendon E (December 2016).

9883: 9834: 9771: 9714: 9679: 9559: 9521: 9472: 9350: 9311: 9257: 9171: 9147: 9132: 9040: 8996: 8938: 8854: 8774: 8725: 8607: 8566: 8523: 8488: 8480: 8452: 8434: 8403: 8367: 8332: 8283: 8239: 8187: 8146: 8137: 8120: 8082: 8040: 7920: 7876: 7835: 7799: 7750: 7671: 7622: 7531: 7459: 7377: 7335: 7240: 7181: 7132: 7086: 7035: 6970: 6887: 6827: 6776: 6735: 6675: 6640: 6564: 6431: 6356: 6312: 6158: 6110: 6050: 5970: 5913: 5877: 5818: 5783: 5747: 5698: 5586: 5472: 5403: 5359: 5324: 5264: 5215: 5174: 5110: 5058: 5022: 4971: 4916: 4867: 4808: 4759: 4708: 4667: 4534: 4419: 4265: 4177: 4133: 4029: 3980: 3923: 3875: 3829: 3783: 3758: 3694: 3647: 3607: 3570: 3450: 3402: 3364: 3312: 3270: 3175: 3104: 3028: 2824: 2811:

in 1954 marked a new era in the evaluation of heart failure. In the 1960s,

2679: 2663: 2638: 2622: 2593: 2240: 2208: 2192: 2045: 2041: 1785: 1753: 1616: 1608: 1585: 1581: 1186: 1034: 975: 815: 773: 721: 679: 675: 592: 286: 282: 9600: 9426: 9399: 9223: 8074: 7614: 6064:

Loscalzo J, Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL (2008).

5952: 5858: 4740: 3151: 2600:

have increased, which have in turn raised the incidence of heart failure.

1533:

Ultrasound of the lungs showing edema due to severe systolic heart failure

1014: 11251: 11149: 10939: 10856: 10838: 10664: 10637: 10588: 10529: 10294: 8515: 7286: 7123: 4604: 3549:

National Guideline Centre (UK) (September 2018). "1. Guideline summary".

2875: 2828: 2656: 2424: 2266: 2152:(e.g., gradual increase in intensity and duration of exercise training), 2095: 2033: 1917:

for it. It is also indicated by congestion of the pulmonary circulation.

1910: 1860:

to NYHA class II and III, while ACC stage D overlaps with NYHA class IV.

1777: 1757: 1719: 1604: 1468: 1426:

implies that the muscle damage has resulted in enlargement of the heart.

1236: 1157: 851: 823: 797: 561: 314: 143: 9623:"A Glimpse of Yesterday: Treatment of "Dropsy" (Slides with Transcript)" 9123: 6023:

Al Deeb M, Barbic S, Featherstone R, Dankoff J, Barbic D (August 2014).

4848: 2854:

in the United Kingdom, and more than $ 35 billion in the United States.

1369:

More accurate classification of heart failure type is made by measuring

11279: 10829: 10305: 9374:"An Eighteenth Century treatise on dropsy of the chest (Buchner, 1742)" 7486:(Partial Update . ed.). London (UK): Royal College of Physicians. 7477: 6041: 6024: 5729: 4985:

Carlisi M, Mancuso S, Lo Presti R, Siragusa S, Caimi G (January 2022).

4411: 3440: 2804: 2776: 2368: 2358: 2316: 2285: 2002: 1801: 1715: 1666: 1447: 1310:

Score-based algorithms have been developed to help in the diagnosis of

1090: 1086: 1042: 1038: 1022: 1006: 997:

A number of medications may cause or worsen the disease. This includes

951: 947: 345: 322: 175: 85: 10178: 9966: 8256:

Adler ED, Goldfinger JZ, Kalman J, Park ME, Meier DE (December 2009).

7812: 7317: 6869: 6808: 4839: 4680: 4516: 2740:), a remarkable advance in understanding mechanisms of heart failure. 2408: 2220:

angiotensin receptor-neprilysin inhibitors (ARNI) sacubitril/valsartan

1398:

is a worsening of chronic heart failure symptoms, which can result in

583:

Other signs of left ventricular failure include a laterally displaced

11482: 10115: 8502:

Neubauer S (March 2007). "The failing heart--an engine out of fuel".

7114: 5937:"Ischemic Heart Disease: Noninvasive Imaging Techniques and Findings" 5190:"2018 ESC/ESH Guidelines for the management of arterial hypertension" 4790: 4152:"The Role of the Clinical Examination in Patients With Heart Failure" 3725:"Exercise-based cardiac rehabilitation for adults with heart failure" 2610: 1964: 1872: 1727: 1161: 1109: 1105: 1082: 1078: 1046: 1030: 967: 906: 789: 674:. Physical examination may reveal pitting peripheral edema, ascites, 639: 635: 615: 584: 577: 560:

or crackles heard initially in the lung bases and when severe in all

553: 396:

may sometimes be recommended. In some moderate or more severe cases,

385: 302: 180: 8683:(24th ed.). Philadelphia: Elsevier Saunders. pp. 303–317. 8658:(24th ed.). Philadelphia: Elsevier Saunders. pp. 295–302. 8296: 6790:

Bashi N, Karunanithi M, Fatehi F, Ding H, Walters D (January 2017).

3778:. National Clinical Guideline Centre. August 2010. pp. 71–153. 3007:

National Guideline Centre (UK) (September 2018). "2. Introduction".

2542:

disease is associated with an overall annual mortality rate of 10%.

1808:

may be used to identify possibilities for revascularisation through

148:

Smoking, sedentary lifestyle, obesity, exposure to second-hand smoke

11205: 10362: 9575:"Historical note. On the contributions of Paracelsus to nephrology" 8416: 5187: 3602:. National Clinical Guideline Centre. August 2010. pp. 34–47. 3307:. National Clinical Guideline Centre. August 2010. pp. 38–70. 2891: 2772: 2760: 2671: 2589: 2303:

Second-line medications for CHF do not confer a mortality benefit.

1793: 1414: 1210: 1195: 1149: 1141: 1133: 1010: 898: 890: 807: 757: 713: 705: 627: 573: 478: 458: 446: 221: 9488:"Historical perspective on heart function: the Frank–Starling Law" 8933:(172). Rockville, MD: Agency for Healthcare Research and Quality. 8796:(162). Rockville, MD: Agency for Healthcare Research and Quality. 3947:"Patient-identified factors related to heart failure readmissions" 3797: 3795: 3793: 2763:

genus of plants in the treatment of edema; their extract contains

1846:

Stage B: A structural heart disorder, but no symptoms at any stage

939: 556:

and labored breathing (nonspecific signs of shortness of breath).

453:– caused by the failure of the heart to pump blood to support the 9948: 5934: 4455: 2788: 2597: 2514: 2475: 2404: 2304: 1906: 1867:

Whether the problem is primarily increased venous back pressure (

1624: 1137: 835: 634:

function can lead to symptoms of poor systemic perfusion such as

611: 525: 466: 255: 11417: 9413:

Eknoyan G (June 1997). "A history of edema and its management".

8118: 7984:"FDA Approves Optimizer Smart System for Heart Failure Patients" 7048: 6991: 6276: 6022: 4822:

Nuyujukian DS, Koska J, Bahn G, Reaven PD, Zhou JJ (July 2020).

3167: 2580:

likely to be diagnosed with heart failure and at a younger age.

2448:

People with the most severe heart failure may be candidates for

53:

Congestive heart failure (CHF), congestive cardiac failure (CCF)

11285: 11265: 10420: 10213: 10190: 10140:

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure

8380: 7897: 6840: 4984: 3790: 2752: 2521:) is used as an indicator of prognosis. As a general rule, a VO 2029: 1878:

Whether the abnormality is due to low cardiac output with high

1723: 1275: 1233: 1145: 886: 847: 709: 489: 417: 267: 250:. The severity of the heart failure is mainly decided based on 170:

Kidney failure, thyroid disease, liver disease, anemia, obesity

59: 9202:

Nolan J (April 1993). "A historical review of heart failure".

8871:. US Centers for Disease Control and Prevention. 15 May 2023. 8203: 7766:"Devices in the management of advanced, chronic heart failure" 6934: 6586:"Acute heart failure with dyspnoea. First-choice treatments". 6088: 3672: 3625: 3548: 3076: 3006: 2779:; in the 19th century they were used by noted physicians like 650: 9062:

Solanki P (2015). "Heart Failure in South Asian Population".

7414:

Liu F, Chen Y, Feng X, Teng Z, Yuan Y, Bin J (5 March 2014).

5842:"Electrical Ventricular Remodeling in Dilated Cardiomyopathy" 5662: 4772: 3847: 2710: 1781: 1756:(low serum sodium concentration) is common in heart failure. 1358: 1229: 557: 513: 470: 425: 232: 225: 105: 9327: 9148:"Ancient Egyptian medicine and the concept of heart failure" 8258:"Palliative care in the treatment of advanced heart failure" 7049:

Amirova A, Fteropoulli T, Williams P, Haddad M (June 2021).

6992:

Amirova A, Fteropoulli T, Williams P, Haddad M (June 2021).

6937:"Reduced Salt Intake for Heart Failure: A Systematic Review" 6699: 6373:

Cells, Tissues, and Disease: Principles of General Pathology

6063: 5711: 5375: 2755:

for acute shortage of breath due to heart failure. In 1785,

2747:, continued through the centuries. Along with bloodletting, 2231:

should be used in those who still have symptoms while on an

2201:

sodium/glucose cotransporter 2 inhibitors (SGLT2 inhibitors)

748:

ventricular failure is not as deleterious to the left side.

9812: 8159: 6135: 5890: 2432: 2343:

recommends screening for iron deficiency and treating with

2094:(calculation of fluid intake and excretion) and monitoring 1826:

New York Heart Association (NYHA) functional classification

1314:, which can be challenging for physicians to diagnose. The 843: 8818: 6789: 5444: 5228: 5138: 5035: 4721: 4501:"The modern diagnosis and management of pleural effusions" 4111: 3993: 2725:

in 1903, facilitated the investigation of heart failure.

2158:

Monitoring of physical activity by others without feedback

1681:, and presence of conduction delay or abnormalities (e.g. 842:. An uncommon cause is exposure to certain toxins such as 662:(cor pulmonale), which is typically caused by issues with 8925:

Hines AL, Barrett ML, Jiang HJ, Steiner CA (April 2014).

8703: 8345: 8255: 8053: 7508: 6092: