Heart Failure

Disease State Hub

Commentary

Heart failure

Understanding the HF Decision Pathways Report

10/01/2018

In this commentary, Dr James Januzzi explains the American College of Cardiology’s Expert Consensus Decision Pathway for managing chronic HFrEF.

10/01/2018

Heart Failure Snapshot

Reviewed by Michael Bloch, MD

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Heart failure is a chronic condition occurring when the heart cannot pump enough blood and oxygen to support the function of other organs.

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HF Specialists, Cardiologists, Nurse Practitioners, Physician Assistants, Hospitalists, Primary Care Physicians, Pharmacists

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Symptoms include shortness of breath during usual activities or while lying down, cough, water retention, weight gain, swelling in feet, legs, ankles, or stomach, rapid heartbeat, and fatigue.

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Blood test, chest x-ray, electrocardiogram, stress test, cardiac CT scan, MRI, coronary angiogram, myocardial biopsy, right heart catheterization

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Hypertensio n, d iabete s, o besity, valvular heart disease, c oronary artery disease, s moking tobacco , eating foods high in fat, cholesterol, and sodium, not getting enough physical activity, and excessive alcohol intake

The four classes of the New York Heart Association Classification

Class I: No HF symptoms
Class II: Exertion causes shortness of breath or fatigue
Class III: Difficulty completing everyday activities
Class IV: Shortness of breath occurs at rest

American College of Cardiology/American Heart Association Stages of Heart Failure

Stage A: Several risk factors, no HF signs/symptoms
Stage B: Heart disease, no HF signs/symptoms
Stage C: Heart disease & signs of HF
Stage D: Requires specialized treatment

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The number of women at high cardiovascular risk who did not accept their physician's initial recommendation of statin therapy.

Ref: Brown et al.

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The lifetime risk of heart failure remains high: 20% to 45% after the age of 45 across all ethnic and racial groups.

Ref: Tsao et al.

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