Heart Failure Overview Quiz

Heart failure (HF) is a condition characterized by symptoms and signs resulting from abnormalities in the heart's structure or function, leading to reduced cardiac output or increased filling pressures during rest or exertion. It's a complex syndrome caused by various underlying issues and requires treatment focused on the root cause.

The prevalence of heart failure increases with age. About 1% of individuals in their 50s, 4% in their 60s, and a staggering 25% in their 80s are affected. The ratio of men to women with heart failure is approximately 1.1:1.

Ejection fraction (EF) is the percentage of blood pumped out of the left ventricle with each heartbeat. Normal EF is ≥ 50%. Reduced EF (< 40%) indicates problems with the heart's ability to contract (systolic heart failure). Preserved EF (≥ 50%) suggests a problem with the heart's ability to relax and fill with blood (diastolic heart failure). EF between 41% and 49% is considered mildly reduced.

Low-output failure is a type of heart failure where the heart cannot pump enough blood to meet the body's needs. High-output failure, on the other hand, is NOT considered heart failure. In high-output failure, the heart is working hard but still cannot deliver enough blood (oxygen) due to an underlying condition like anemia or hyperthyroidism.

Left-sided heart failure affects the left ventricle and is the more common type. Right-sided heart failure, which affects the right ventricle, is less frequent. It can occur due to a lung issue (cor pulmonale), heart attack on the right side, heart muscle disease, high pressure in the pulmonary arteries, or blood clots in the lungs. It often develops as a consequence of left-sided failure due to fluid backup.

Acute heart failure comes on quickly or worsens rapidly, potentially leading to life-threatening situations and necessitating immediate hospitalization. It can be a worsening of chronic heart failure or a new onset. Chronic heart failure usually develops due to irreversible damage to the heart muscle caused by an underlying condition. This condition is ongoing and likely worsens without treatment. Episodes of acute decompensation (worsening symptoms) greatly impact long-term survival.

Heart failure can affect the heart's function in three ways: reduced ability of the heart muscle to contract, problems with the heart relaxing and filling with blood, or blockage of the heart's pumping mechanism.

Heart failure can be caused by many factors including high blood pressure, heart attacks, heart valve problems, or infections. These factors can lead to weakened heart muscles and limit the heart's ability to function properly.

Heart failure can manifest with various symptoms such as shortness of breath, fatigue, swelling in the legs and ankles, rapid heartbeat, and coughing. These symptoms can occur at rest or during physical activity.

The prognosis of heart failure varies widely depending on risk factors and the severity of the condition. After diagnosis, the average 1-year mortality rate is around 20%, and the 5-year mortality rate is approximately 50%.