SHM's Clinical Quick Talks-Heart Failure

Pdf Summary

Heart failure occurs when the heart is unable to pump enough blood to meet the body's needs. It affects 5.1 million people in the US and 23 million people worldwide. There are different types of heart failure, including left-sided heart failure and high output heart failure. Left-sided heart failure can be caused by various factors such as decreased contractility, increased afterload, decreased forward flow, diastolic dysfunction, or pericardial disease. The pathophysiology involves decreased cardiac output, activation of the RAAS system, activation of the sympathetic nervous system, systemic vasoconstriction, and volume retention. Symptoms of heart failure include fatigue, weakness, exercise intolerance, dyspnea, orthopnea, peripheral edema, and others.<br /><br />Diagnosis of heart failure can be done through various methods such as chest x-ray, BNP/NT-proBNP levels, evidence of decreased organ perfusion, EKG, echocardiogram, PA catheterization, and clinical signs. Management of heart failure with reduced ejection fraction (HFrEF) includes the use of beta-blockers, ACE inhibitors/ARBs, mineralocorticoid receptor antagonists, and device therapy such as cardiac resynchronization devices. Beta-blockers such as carvedilol and metoprolol have shown to reduce the risk of death or HF hospitalization. ACE inhibitors/ARBs like enalapril and valsartan have shown to reduce mortality and hospitalizations. Mineralocorticoid receptor antagonists like epelerone and spironolactone have also shown to reduce the risk of death and hospitalization. In certain populations, specific treatments may be beneficial, such as isosorbide dinitrate and hydralazine for African-Americans or ivabradine for patients with a high heart rate. Device therapy through the use of cardiac resynchronization devices or ICDs can also help reduce mortality and HF events.<br /><br />Overall, heart failure is a prevalent condition that requires proper diagnosis and management to improve outcomes and quality of life for affected individuals.

Asset Subtitle

Brad Fedor

Meta Tag

Core Competency Heart Failure

Keywords

heart failure

pump

blood

types

left-sided heart failure

high output heart failure

pathophysiology

symptoms

diagnosis

management