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Definition of CHF
•Complex syndrome
•Impaired function of the heart
•Compromised peripheral perfusion
Epidemiology• Prevalence in Europe: 2 %
• Prevalence > 65 yrs: 10 %
• 1st year mortality: 30 – 40 %
• 5 year mortality: 60 – 70 %
Clinical characteristics
•Left heart failure
•Right heart failure
•Biventricular (congestive) heart failure
Aetiology• Cardiac pathology
Ischaemic heart disease
Hypertensive heart disease
Cardiomyopathy
Valvular heart disease
Congenital heart disease
Pericardial disease
Aetiology• Extracardiac pathology
Pulmonary disease: pulmonary embolism
Endocrine and metabolic disease
Infective disease
Toxic substances: alcohol
Pathophysiology• Sympathetic activation
Increased heart rate
Increased myocardial contractility
Venous vasoconstriction
Arteriolar vasoconstriction
Clinical features
•Left heart failure
Paroxysmal nocturnal dyspnoea
Orthopnoea
Basal lung crackles
Presence of the third heart sound
Treatment
•Vasodilator therapy
ACE inhibitors
Angiotensin II receptor antagonists
Nitrates
Hydralazine
References
•Vrhovac B et al: Interna medicina, Naklada Ljevak, 2008
•Ballinger A, Patchett S: Pocket Essentials of Clinical Medicine, Elsevier Saunders, 2007
•United States National Library of Medicine (nlm.nih.gov)
•Wikipedia (wikipedia.org)
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