From the Guidelines
Heart failure is a clinical syndrome with symptoms and/or signs caused by a structural and/or functional cardiac abnormality and corroborated by elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion, as defined by major worldwide scientific bodies in 2021 1. This definition emphasizes the importance of both clinical presentation and objective evidence in diagnosing heart failure. The condition can result from various underlying causes, including coronary artery disease, high blood pressure, heart valve problems, cardiomyopathy, or congenital heart defects.
Key Characteristics of Heart Failure
- Reduced ability of the heart to pump and/or fill with blood
- Symptoms such as shortness of breath, fatigue, and fluid retention
- Classification based on ejection fraction (reduced, preserved, or mid-range) and symptom severity (NYHA Class I-IV)
Diagnosis and Management
The diagnosis of heart failure is largely clinical, based on a careful history and physical examination, with no single diagnostic test available 1. Management involves medications like ACE inhibitors, beta-blockers, diuretics, and SGLT2 inhibitors, along with lifestyle modifications such as sodium restriction, regular exercise, and fluid management.
Goals of Treatment
- Improve quality of life
- Reduce hospitalizations
- Extend survival by addressing both the underlying causes and the resulting symptoms of impaired cardiac function Given the most recent and highest quality evidence, the definition of heart failure as a clinical syndrome with specific symptoms and signs, corroborated by objective evidence, should be used in clinical practice to guide diagnosis and management decisions 1.
From the Research
Definition of Heart Failure
- Heart failure (HF) is a complex syndrome characterized by the inability of the heart to maintain a normal cardiac output without elevated intracardiac filling pressures, resulting in signs of pulmonary and peripheral edema and symptoms of dyspnea and fatigue 2.
- HF is a clinical syndrome caused by a decline in cardiac systolic or diastolic function, which leaves the heart unable to pump enough blood to meet the normal physiological requirements of the human body 3.
- It is a heterogeneous clinical syndrome stemming from cardiac overload and injury that leads to considerable morbidity and mortality 4.
- HF is a complex clinical syndrome characterized by different etiologies and a broad spectrum of cardiac structural and functional abnormalities 5.
- Heart failure is a clinical syndrome that results when the heart is unable to provide sufficient blood flow to meet metabolic requirements or accommodate systemic venous return 6.
Key Characteristics
- HF is characterized by defects in energy production and changes in metabolic pathways involved in the regulation of essential cellular functions 3.
- It is associated with symptoms such as dyspnea, fatigue, peripheral edema, and ascites 2, 6.
- The transition from one stage to the next is associated with a worse prognosis 5.
- HF results from injury to the myocardium from a variety of causes including ischemic heart disease, hypertension, and diabetes 6.