Overview
Definition
A complex clinical syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood.
Epidemiology
Affects ~64 million people globally. Prevalence increases significantly with age.
Etiology & Risk Factors
- Ischemic heart disease / Myocardial Infarction
- Hypertension
- Valvular heart disease
- Cardiomyopathy (dilated, hypertrophic, restrictive)
Clinical Symptoms
- Dyspnea on exertion
- Orthopnea / Paroxysmal nocturnal dyspnea (PND)
- Peripheral edema
- Fatigue
- Jugular venous distention (JVD)
Clinical Approach
Diagnosis
- Echocardiogram (assess Ejection Fraction - HFrEF vs HFpEF)
- BNP or NT-proBNP levels
- Chest X-ray (cardiomegaly, pulmonary edema)
- ECG (evaluate for arrhythmias/ischemia)
Management
- ACE Inhibitors / ARBs / ARNIs (Sacubitril/Valsartan)
- Beta-blockers (Carvedilol, Metoprolol succinate, Bisoprolol)
- SGLT2 inhibitors (Dapagliflozin, Empagliflozin)
- Aldosterone Antagonists (Spironolactone)
- Diuretics (Furosemide) for symptom relief
Complications
- Arrhythmias (Atrial Fibrillation, VT)
- Cardiogenic shock
- Renal failure (Cardiorenal syndrome)
- Liver congestion (Cardiac cirrhosis)