Heart Failure Definition and Classification

Heart failure (HF) is a condition where the heart is unable to pump enough blood to meet the body's needs.
Classified into two main categories:
- Left-sided heart failure: affects the left ventricle, leading to congestion in the lungs and pulmonary edema.
- Right-sided heart failure: affects the right ventricle, leading to congestion in the peripheral tissues and organs.

New York Heart Association (NYHA) classification:
- Class I: no symptoms
- Class II: mild symptoms
- Class III: moderate symptoms
- Class IV: severe symptoms

Treatment goals:
- Reduce symptoms
- Improve quality of life
- Increase survival
Medications:
- ACE inhibitors or ARBs
- Beta blockers
- Diuretics
- Inotropes
- Aldosterone antagonists
Lifestyle modifications:
- Sodium restriction
- Fluid restriction
- Exercise training
- Stress reduction
- Smoking cessation
Device therapy:
- Implantable cardioverter-defibrillators (ICDs)
- Cardiac resynchronization therapy (CRT)
Surgical interventions:
- Heart transplantation
- Ventricular assist devices (VADs)

Heart failure is a condition where the heart is unable to pump enough blood to meet the body's needs.
There are two main categories of heart failure: left-sided and right-sided.
Left-sided heart failure affects the left ventricle, leading to congestion in the lungs and pulmonary edema.
Right-sided heart failure affects the right ventricle, leading to congestion in the peripheral tissues and organs.

Common causes of heart failure include coronary artery disease, hypertension, cardiomyopathy, heart valve problems, arrhythmias, viral infections, and chronic kidney disease.
Coronary artery disease is a major cause of heart failure, as it can lead to reduced blood flow to the heart.

Decreased cardiac output leads to increased sympathetic nervous system activity, which increases heart rate and blood pressure.
Decreased cardiac output also leads to increased renin-angiotensin-aldosterone system activity, which causes fluid retention and edema.
Fluid retention and edema can lead to vasoconstriction and increased blood pressure.
Decreased peripheral perfusion and oxygen delivery can lead to fatigue and weakness.

Common symptoms of heart failure include shortness of breath (dyspnea), fatigue, swelling in the legs, ankles, and feet (edema), rapid or irregular heartbeat, coughing or wheezing, and chest pain or discomfort.
Shortness of breath can occur due to congestion in the lungs and pulmonary edema.
Fatigue can occur due to decreased peripheral perfusion and oxygen delivery.

Diagnostic tests for heart failure include echocardiogram, electrocardiogram (ECG), chest X-ray, blood tests (e.g., BNP, troponin), and cardiac catheterization.
Echocardiogram can help diagnose heart failure by evaluating heart function and structure.

The New York Heart Association (NYHA) classification system is used to stage heart failure, with Class I being no symptoms and Class IV being severe symptoms.
Patients with Class I heart failure have no symptoms, while patients with Class IV heart failure have severe symptoms.

Treatment goals for heart failure include reducing symptoms, improving quality of life, and increasing survival.
Medications used to treat heart failure include ACE inhibitors or ARBs, beta blockers, diuretics, inotropes, and aldosterone antagonists.
ACE inhibitors or ARBs can help reduce blood pressure and improve heart function.
Lifestyle modifications, such as sodium restriction, fluid restriction, exercise training, stress reduction, and smoking cessation, can also help manage heart failure.
Device therapy, such as implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy (CRT), can also be used to treat heart failure.
Surgical interventions, such as heart transplantation and ventricular assist devices (VADs), can be used in severe cases of heart failure.