cardiovascular disorders
Heart Failure (HF)
Key Points
Heart failure (HF) involves ventricular dysfunction that ultimately leads to the heart not providing tissues with adequate blood for metabolic needs. In heart failure with reduced ejection fraction (HFrEF), the ventricle contracts poorly and empties inadequately; ejection fraction is low. In heart failure with preserved ejection fraction (HFpEF), ventricular filling is impaired, resulting in increased end-diastolic pressure at rest and/or during exercise; ejection fraction is normal. Consider HF in patients with exertional dyspnea or fatigue, orthopnea, and/or edema, particularly in those with a history of myocardial infarction, hypertension, or valvular disorders or murmurs. Do chest x-ray, ECG, BNP levels, and an objective test of cardiac function, typically echocardiography. Unless adequately treated, HF tends to progress and has a poor prognosis. Treatment includes education and lifestyle changes, control of underlying disorders, a variety of drugs, and sometimes implantable devices (CRT, ICDs). 