Heart Failure
Overview of Heart failure
Congestive
heart failure,
also known as heart failure (HF) is a condition which results from any structural or functional heart disorder that impairs the heart’s ability to pump sufficient blood through the body. Although HF can occur at any age, it is more common among the elderly people as age-related changes tend to reduce the functional efficiency of the heart. Further, this group of the population is more likely to have disorders that damage the heart muscle.
Heart failure constitutes a major public health problem in theWestern world. This condition affects nearly five million Americans with anincidence nearly 10 per 1000 persons among individuals above 65 years of age.1 Five-year survival rates of HF patients had been estimated to be only 45% in women and 59% in men.2
The diagnosisof HF is complex. Early diagnosis of HF is essential in order to adequately control the underlying disease or causes. Evaluation of symptomatic patients with suspected HF focuses on confirming the diagnosis, determining the cause, identifying concomitant illnesses, establishing the severity and directing the therapy. The goals of the HF therapy include targets on improving the survival by slowing down the disease progression, alleviating the symptoms and minimizing the risk factors. Lifestyle modificationshelp in controlling the symptoms and improving the quality of life.
Classification of Heart failure
There are many different ways to classify heart failure . Each depends upon the following criteria:
- The side of the affected heart—left HF or right HF.
- The type of the abnormality—either due to contraction (systolic dysfunction) or relaxation (diastolic dysfunction) of the heart.
- The cause of the failure—either due to low cardiac output or high systemic vascular resistance (low- vs. high-output failure).
- The extent of functional impairment caused by the abnormality.
The New York Heart Association (NYHA) Functional Classification which documents severity of symptoms is widely used in the clinical practice and in clinical studies to quantify the clinical assessment of HF and to assess response to the treatment.3
The NYHA functional classifications based on physical activities are:
- Class I: No limitation in any activities.
- Class II: Mild limitation of activity.
- Class III: Marked limitation of any activity.
- Class IV: Symptoms of heart failure occur even at rest.
Symptoms of Heart failure determined by side of the heart (left or right), which fails. The clinical features of heart failure are mainly due to an accumulation of fluid in the lungs and the body.
Diagnosis of Heart failure
Diagnosis of Heart failure
The initial evaluation should include a complete history and physical examination, a chest radiograph and an electrocardiogram (ECG).
Teatment of Heart failure
Treatment of Heart failure
The management of heart failure depends on its cause and clinical course, therefore an individualized approach to the treatment is mandatory.
Related article:
Anatomy of the heart
Written by: Healthplus24 team
Date last updated: April 15, 2012