From the Guidelines
Heart failure presents with several key signs, including shortness of breath, persistent coughing or wheezing, fatigue and weakness, rapid or irregular heartbeat, reduced ability to exercise, swelling in the legs, ankles, and feet, and sudden weight gain from fluid retention, as defined by the American College of Cardiology/American Heart Association task force on clinical data standards 1. The signs of heart failure can be categorized into symptoms and physical examination findings. Symptoms may include:
- Dyspnea (dyspnea with exertion, dyspnea at rest, orthopnea, paroxysmal nocturnal dyspnea, nocturnal cough in supine position, tachypnea)
- Decreased exercise tolerance
- Fatigue
- Worsened end-organ perfusion
- Other symptoms of volume overload (swelling of lower extremities, increase in abdominal girth, right-sided abdominal fullness, discomfort, or tenderness) Physical examination findings may include:
- Peripheral edema
- Increasing abdominal distention or ascites
- Pulmonary rales/crackles/crepitations
- Increased jugular venous pressure and/or hepatojugular reflux
- S 3 gallop
- Clinically significant or rapid weight gain thought to be related to fluid retention Laboratory evidence of heart failure may include increased BNP or NT-proBNP concentrations, and radiological evidence of pulmonary congestion 1. It is essential to note that the severity of symptoms often correlates with how much the heart's pumping capacity has decreased, and early treatment can improve outcomes and quality of life 1. The American College of Cardiology/American Heart Association task force on clinical data standards provides a comprehensive definition of heart failure symptoms and signs, which is crucial for accurate diagnosis and management 1.
From the Research
Signs of Heart Failure
The signs of heart failure are not explicitly stated in the provided studies, but we can infer some information about heart failure from the texts.
- Heart failure (HF) can be caused by various factors, including coronary artery disease (CAD) and hypertension 2.
- The life-time risk of developing HF is about 20%, and this risk increases to 40% if hypertension is present 2.
- Heart failure can be classified into two main types: systolic HF and diastolic HF, with CAD being a main cause of systolic HF and hypertension being a main cause of diastolic HF 2.
- Beta-blockers and ACE inhibitors are commonly used to treat heart failure, and their combination has been shown to be effective in reducing mortality and improving patient outcomes 3, 4, 5.
- The treatment of heart failure often involves a combination of medications, including beta-blockers, ACE inhibitors, aldosterone antagonists, and angiotensin receptor blockers 4.
- The choice of beta-blocker is important, as some beta-blockers (such as bisoprolol, metoprolol, and carvedilol) have been shown to be more effective than others in treating heart failure 2, 5.