Heart failure

Disease class: Heart diseases

Clinical states

• "Wet and warm" (congested venous system, adequate perfusion)
• "Wet and cold" (congested venous system, hypoperfusion)
• "Dry and warm" (uncongested venous system, adequate perfusion)
• "Dry and cold" (uncongested venous system, hypoperfusion)

 

Physiology

• Heart

Pathophysiology

• The right heart draws blood from the body and pushes it to the lungs.
• The left heart draws blood from the lungs and pushes it to the body.
• As the right sided system fails, the heart cannot draw blood from the body, so patients will notice swelling (oedema), particularly in their ankles because gravity pulls the fluid down to the feet. 
• As the left sided system fails, the heart cannot draw blood from the lungs, so fluid will accumulate in the lungs, causing breathlessness. The heart cannot push blood to the body with sufficient mean arterial pressure to maintain adequate perfusion of tissues and organs.

 

Aetiology

 

Management 

1. Diagnosis 
2. Functional classification
3. Pharmacological treatment

 

References

1. Piotr Ponikowski, Adriaan A Voors, Stefan D Anker, Héctor Bueno, John G F Cleland, Andrew J S Coats, Volkmar Falk, José Ramón González-Juanatey, Veli-Pekka Harjola, Ewa A Jankowska, Mariell Jessup, Cecilia Linde, Petros Nihoyannopoulos, John T Parissis, Burkert Pieske, Jillian P Riley, Giuseppe M C Rosano, Luis M Ruilope, Frank Ruschitzka, Frans H Rutten, Peter van der Meer, ESC Scientific Document Group, 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)
   Developed with the special contribution of the Heart Failure Association (HFA) of the ESC, European Heart Journal, Volume 37, Issue 27, 14 July 2016, Pages 2129–2200, https://doi.org/10.1093/eurheartj/ehw128