Congestive heart failure: Difference between revisions

	Congestive Heart Failure Microchapters
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Patient Information
Overview
Historical Perspective
Classification
Pathophysiology Systolic Dysfunction Diastolic Dysfunction HFpEF HFrEF
Causes
Differentiating Congestive heart failure from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Clinical Assessment
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
Cardiac MRI
Echocardiography
Exercise Stress Test
Myocardial Viability Studies
Cardiac Catheterization
Other Imaging Studies
Other Diagnostic Studies
Treatment
Invasive Hemodynamic Monitoring
Medical Therapy:
Summary
Acute Pharmacotherapy
Chronic Pharmacotherapy in HFpEF
Chronic Pharmacotherapy in HFrEF Diuretics ACE Inhibitors Angiotensin receptor blockers Aldosterone Antagonists Beta Blockers Ca Channel Blockers Nitrates Hydralazine Positive Inotropics Anticoagulants Angiotensin Receptor-Neprilysin Inhibitor Antiarrhythmic Drugs Nutritional Supplements Hormonal Therapies Drugs to Avoid Drug Interactions Treatment of underlying causes Associated conditions
Exercise Training
Surgical Therapy: Biventricular Pacing or Cardiac Resynchronization Therapy (CRT) Implantation of Intracardiac Defibrillator Ultrafiltration Cardiac Surgery Left Ventricular Assist Devices (LVADs) Cardiac Transplantation
ACC/AHA Guideline Recommendations Initial and Serial Evaluation of the HF Patient Hospitalized Patient Patients With a Prior MI Sudden Cardiac Death Prevention Surgical/Percutaneous/Transcather Interventional Treatments of HF Patients at high risk for developing heart failure (Stage A) Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B) Patients with current or prior symptoms of heart failure (Stage C) Patients with refractory end-stage heart failure (Stage D) Coordinating Care for Patients With Chronic HF Quality Metrics/Performance Measures
Implementation of Practice Guidelines
Congestive heart failure end-of-life considerations
Specific Groups: Special Populations Patients who have concomitant disorders Obstructive Sleep Apnea in the Patient with CHF NSTEMI with Heart Failure and Cardiogenic Shock
Congestive heart failure On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Congestive heart failure
CDC on Congestive heart failure
Congestive heart failure in the news
Blogs on Congestive heart failure
Directions to Hospitals Treating Congestive heart failure
Risk calculators and risk factors for Congestive heart failure

VisualWikitext

Latest revision as of 22:20, 19 April 2023

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2], Mitra Chitsazan, M.D.[3] Seyedmahdi Pahlavani, M.D. [4] Syed Hassan A. Kazmi BSc, MD [5] Edzel Lorraine Co, D.M.D., M.D. [6]

Synonyms and keywords: CHF; pump failure; left heart failure; chronic heart failure; acute heart failure; LV dysfunction; LV failure; impaired filling; reduced cardiac output; HFpEF; HFrEF; heart failure preserved ejection fraction; heart failure reduced ejection fraction; decompensated heart failure; acute decompensated heart failure; ADHF

Overview

Classification

Pathophysiology

Systolic dysfunction | Diastolic dysfunction | HFpEF | HFrEF

Causes

Differentiating Chronic Heart Failure from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

Treatment

Treatment of Heart failure with reduced ejection fraction

Pharmacological treatments for patients with heart failure with reduced ejection fraction:

In all patients: Angiotensin-converting enzyme inhibitors | Beta Blockers | Aldosterone Antagonists | Angiotensin Receptor-Neprilysin Inhibitor | Sodium-glucose co-transporter 2 inhibitors
In selected patients: Diuretics | Angiotensin receptor blockers | I_f-channel inhibitor | Combination of hydralazine and isosorbide dinitrate | Digoxin | Iron

Guideline-recommended medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) can be suggested by the Heart Failure Educational Decision Aid medication optimization algorithm^[1].

Cardiac rhythm management for patients with heart failure with reduced ejection fraction: Antiarrhythmic drugs | Implantable cardioverter defibrillator | Cardiac resynchronization therapy

Nutritional supplements and hormonal therapies

Exercise training

Drugs to avoid

Drug interactions

Treatment of underlying causes

Treatment of associated conditions

Treatment of Heart failure with preserved ejection fraction

Management of Acute heart failure

Management of Advanced heart failure

Ultrafiltration | Mechanical circulatory support | Heart transplantation

ACC/AHA Guideline Recommendations

Hospitalized Patients

Patients With a Prior MI

Sudden Cardiac Death Prevention

Stage A: Patients at High Risk for Developing Heart Failure

Stage B: Patients with Cardiac Structural Abnormalities

Stage C: Patients with Current or Prior Heart Failure Symptoms

Stage D: Patients with Refractory End-stage Heart Failure

Implementation of Practice Guidelines

End-Of-Life Considerations

Specific Groups

Special Populations | Patients who have concomitant disorders | Obstructive Sleep Apnea in the Patient with CHF

References

↑ Dorsch, Michael P.; Sifuentes, Aaron; Cordwin, David J.; Kuo, Rachel; Rowell, Brigid E.; Arzac, Juan J.; DeBacker, Ken; Guidi, Jessica L.; Hummel, Scott L.; Koelling, Todd M. (April 2023). "A Computable Algorithm for Medication Optimization in Heart Failure With Reduced Ejection Fraction". JACC: Advances: 100289. doi:10.1016/j.jacadv.2023.100289. ISSN 2772-963X.

Template:WikiDoc Sources

[DorschSifuentesCordwin2023-1] Dorsch, Michael P.; Sifuentes, Aaron; Cordwin, David J.; Kuo, Rachel; Rowell, Brigid E.; Arzac, Juan J.; DeBacker, Ken; Guidi, Jessica L.; Hummel, Scott L.; Koelling, Todd M. (April 2023). "A Computable Algorithm for Medication Optimization in Heart Failure With Reduced Ejection Fraction". JACC: Advances: 100289. doi:10.1016/j.jacadv.2023.100289. ISSN 2772-963X.

[1]

@@ Line 1: / Line 1: @@
-'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
+__NOTOC__
+{| class="infobox" style="float:right;"
+|-
+| [[File:Siren.gif|30px|link= Heart failure resident survival guide]]|| <br> || <br>
+| [[Heart failure resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
+|}
-{{Infobox_Disease |
+{{Congestive heart failure}}
-  Name           = Heart failure |
-  Image          = |
+{{CMG}}; {{AE}} {{LG}}, {{Mitra}} {{MehdiP}} {{HK}} [[User:Edzelco|Edzel Lorraine Co, D.M.D., M.D.]] [Mailto:efco@alum.up.edu.ph]
-  Caption        = |
-  DiseasesDB     = 16209 |
+{{SK}} CHF; pump failure; left heart failure; chronic heart failure; acute heart failure; LV dysfunction; LV failure; impaired filling; reduced cardiac output; HFpEF; HFrEF; heart failure preserved ejection fraction; heart failure reduced ejection fraction; decompensated heart failure; acute decompensated heart failure; ADHF
-  ICD10          = {{ICD10|I|50|0|i|50}} |
-  ICD9           = {{ICD9|428.0}} |
+== [[Congestive heart failure overview|Overview]] ==
-  ICDO           = |
-  OMIM           = |
+== [[Congestive heart failure classification|Classification]] ==
-  MedlinePlus    = 000158 |
-  MeshID         = D006333|
+== [[Congestive heart failure pathophysiology|Pathophysiology]] ==
-}}
+[[Congestive heart failure pathophysiology#Systolic dysfunction|Systolic dysfunction]] | [[Diastolic dysfunction pathophysiology|Diastolic dysfunction]] | [[Congestive heart failure with preserved EF|HFpEF]] | [[Congestive heart failure with reduced EF|HFrEF]]
+== [[Congestive heart failure causes|Causes]] ==
+== [[Congestive heart failure differential diagnosis|Differentiating Chronic Heart Failure from other Diseases]] ==
+== [[Congestive heart failure epidemiology and demographics|Epidemiology and Demographics]] ==
-{{Congestive heart failure}}
+== [[Congestive heart failure risk factors|Risk Factors]] ==
-{{CMG}}; '''Associate Editor(s)-In-Chief:''' {{CZ}}; {{LG}}; Atif Mohammad, M.D.
-'''''Synonyms and Related Key Words:''''' CHF, pump failure, left heart failure, right heart failure, chronic heart failure, acute heart failure, flash pulmonary edema, congestion, systolic dysfunction, LV dysfunction, LV failure, impaired filling, reduced cardiac output, pulmonary edema
+== [[Congestive heart failure natural history|Natural History, Complications and Prognosis]] ==
-==[[Congestive heart failure overview|Overview]]==
+== Diagnosis ==
-==[[Congestive heart failure classification|Classification]]==
+[[Congestive heart failure clinical assessment|Clinical Assessment]] | [[Congestive heart failure history and symptoms|History and Symptoms]] | [[Congestive heart failure physical examination|Physical Examination]] | [[Congestive heart failure laboratory tests|Laboratory Findings]] | [[Congestive heart failure electrocardiogram|Electrocardiogram]] | [[Congestive heart failure chest x ray|Chest X Ray]] | [[Congestive heart failure echocardiography|Echocardiography]] | [[Congestive heart failure cardiac MRI|Cardiac MRI]] | [[Congestive heart failure exercise stress testing|Exercise Stress Test]] | [[Congestive heart failure myocardial viability study|Myocardial Viability Studies]] | [[Congestive heart failure cardiac catheterization|Cardiac Catheterization]] | [[Invasive hemodynamic monitoring]]
-==[[Congestive heart failure pathophysiology|Pathophysiology]]==
+== Treatment ==
-[[Congestive heart failure pathophysiology#Systolic dysfunction|Systolic dysfunction]] | [[Congestive heart failure pathophysiology#Diastolic dysfunction|Diastolic dysfunction]]
-==[[Congestive heart failure epidemiology and demographics|Epidemiology and Demographics]]==
-==[[Congestive heart failure causes|Causes]]==
+=== Treatment of Heart failure with reduced ejection fraction ===
+: '''[[Congestive heart failure Pharmacological treatments for patients with heart failure with reduced ejection fraction|Pharmacological treatments for patients with heart failure with reduced ejection fraction]]''':
+*'''In all patients:''' [[Congestive heart failure Angiotensin-converting enzyme inhibitors|Angiotensin-converting enzyme inhibitors]] | [[Congestive heart failure beta blockers|Beta Blockers]] | [[Congestive heart failure aldosterone antagonists|Aldosterone Antagonists]] | [[Congestive heart failure angiotensin receptor-neprilysin inhibitor|Angiotensin Receptor-Neprilysin Inhibitor]] | [[Congestive heart failure Sodium-glucose co-transporter 2 inhibitors|Sodium-glucose co-transporter 2 inhibitors]]
+*'''In selected patients:''' [[Congestive heart failure diuretics|Diuretics]] | [[Congestive heart failure angiotensin receptor blockers|Angiotensin receptor blockers]] | [[Congestive heart failure If-channel inhibitor|I<sub>f</sub>-channel inhibitor]] | [[Combination of hydralazine and isosorbide dinitrate]] | [[Congestive heart failure Digoxin|Digoxin]] | [[Congestive heart failure iron|Iron]]
-==[[Congestive heart failure risk factors| Risk Factors]]==
+Guideline-recommended medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) can be suggested by the [https://decisionalgorithm.shinyapps.io/heartfailure/ Heart Failure Educational Decision Aid] medication optimization algorithm<ref name="DorschSifuentesCordwin2023">{{cite journal | last1 = Dorsch | first1 = Michael P. | last2 = Sifuentes | first2 = Aaron | last3 = Cordwin | first3 = David J. | last4 = Kuo | first4 = Rachel | last5 = Rowell | first5 = Brigid E. | last6 = Arzac | first6 = Juan J. | last7 = DeBacker | first7 = Ken | last8 = Guidi | first8 = Jessica L. | last9 = Hummel | first9 = Scott L. | last10 = Koelling | first10 = Todd M. | title = A Computable Algorithm for Medication Optimization in Heart Failure With Reduced Ejection Fraction | journal = JACC: Advances | date = April 2023 | page = 100289 | issn = 2772-963X | doi = 10.1016/j.jacadv.2023.100289 | pmid = | url = }}</ref>.
-==[[Congestive heart failure differential diagnosis|Differential Diagnosis]]==
+: '''Cardiac rhythm management for patients with heart failure with reduced ejection fraction''': [[Congestive heart failure Antiarrhythmic drugs|Antiarrhythmic drugs]] | [[Congestive heart failure Implantable cardioverter defibrillator|Implantable cardioverter defibrillator]] | [[Cardiac resynchronization therapy]]
+: '''[[Congestive heart failure Nutritional supplements and hormonal therapies|Nutritional supplements and hormonal therapies]]'''
+: '''[[Congestive heart failure Exercise training|Exercise training]]'''
+: '''[[Congestive heart failure Drugs to avoid|Drugs to avoid]]'''
+: '''[[Congestive heart failure Drug interactions|Drug interactions]]'''
+: '''[[Congestive heart failure Treatment of underlying causes|Treatment of underlying causes]]'''
+: '''[[Congestive heart failure Treatment of associated conditions|Treatment of associated conditions]]'''
-==[[Congestive heart failure natural history|Natural history, complications & prognosis]]==
+=== [[Congestive heart failure Treatment of Heart failure with preserved ejection fraction| Treatment of Heart failure with preserved ejection fraction]] ===
-==Diagnosis==
+=== [[Congestive heart failure Management of Acute heart failure | Management of Acute heart failure]] ===
-[[Congestive heart failure clinical assessment|Clinical Assessment]] | [[Congestive heart failure history and symptoms|History & Symptoms]] | [[Congestive heart failure physical examination|Physical Examination]] | [[Congestive heart failure laboratory tests|Lab Tests]] | [[Congestive heart failure electrocardiogram|Electrocardiogram]] | [[Congestive heart failure chest x ray|Chest X Ray]] | [[Congestive heart failure echocardiography|Echocardiography]] | [[Congestive heart failure cardiac MRI|Cardiac MRI]] | [[Congestive heart failure exercise stress testing|Exercise Stress Test]] | [[Congestive heart failure myocardial viability study|Myocardial Viability Studies]] | [[Congestive heart failure cardiac catheterization|Cardiac Catheterization]] | [[Congestive heart failure endomyocardial biopsy|Endomyocardial biopsy]]
-==Treatment==
+===[[ Management of Advanced heart failure]] ===
+[[Congestive heart failure Ultrafiltration|Ultrafiltration]] | [[Congestive heart failure Mechanical circulatory support| Mechanical circulatory support]] | [[Heart transplantation]]
-====[[Congestive heart failure invasive monitoring|Invasive Hemodynamic Monitoring]]====
+== ACC/AHA Guideline Recommendations ==
-====Medical Therapy:====
+=== [[Congestive heart failure AHA recommendations for hospitalized patient|Hospitalized Patients]] ===
-: '''[[Congestive heart failure acute pharmacotherapy|Acute Pharmacotherapy]]'''
-: '''Chronic Pharmacotherapy:''' [[Congestive heart failure diuretics|Diuretics]] | [[Congestive heart failure ACE inhibitors|ACE Inhibitors]] | [[Congestive heart failure angiotensin receptor blockers|Angiotensin receptor blockers]] | [[Congestive heart failure aldosterone antagonists|Aldosterone Antagonists]] | [[Congestive heart failure beta blockers|Beta Blockers]] | [[Congestive heart failure calcium channel blockers|Ca Channel Blockers]] | [[Congestive heart failure vasodilators|Nitrates]] | [[Congestive heart failure vasodilators|Hydralazine]] | [[Congestive heart failure positive inotropics|Positive Inotropics]] | [[Congestive heart failure anticoagulants|Anticoagulants]] | [[Congestive heart failure antiarrhythmic Drugs|Antiarrhythmic Drugs]] | [[Congestive heart failure other pharmacotherapies#Metformin|Metformin]] | [[Congestive heart failure other pharmacotherapies#Nutritional Supplements|Nutritional Supplements]] | [[Congestive heart failure other pharmacotherapies#Hormonal Therapies|Hormonal Therapies]]
-====[[Congestive heart failure and exercise|Exercise Training]]====
+===[[Congestive heart failure AHA recommendations for patients with a prior MI|Patients With a Prior MI]]===
-====Surgical Therapy:====
+===[[Congestive heart failure sudden cardiac death prevention|Sudden Cardiac Death Prevention]]===
-:[[Congestive heart failure biventricular pacing or cardiac resynchronization therapy|Biventricular Pacing or Cardiac Resynchronization Therapy (CRT)]] | [[Congestive heart failure implantation of intracardiac defibrillator|Implantation of Intracardiac Defibrillator]] | [[Congestive heart failure ultrafiltration|Ultrafiltration]] | [[Congestive heart failure left ventricular assist devices|Left Ventricular Assist Devices (LVADs)]] | [[Congestive heart failure cardiac transplantation|Cardiac Transplantation]] | [[Congestive heart failure cardiac surgery|Cardiac Surgery]]
-==ACC/AHA Guideline Recommendations==
+=== [[Congestive heart failure treatment of patients at high risk for developing heart failure (Stage A)|Stage A: Patients at High Risk for Developing Heart Failure]] ===
-===[[Congestive heart failure AHA recommendations for hospitalized patient|Hospitalized Patients]]===
-===[[Congestive heart failure treatment of patients at high risk for developing heart failure (Stage A)|Stage A: Patients at High Risk for Developing Heart Failure]]===
 [[Congestive heart failure treatment of patients at high risk for developing heart failure (Stage A)#Treatment of Hypertension|Treatment of Hypertension]] | [[Congestive heart failure treatment of patients at high risk for developing heart failure (Stage A)#Treatment of Diabetes Mellitus|Treatment of Diabetes Mellitus]] | [[Congestive heart failure treatment of patients at high risk for developing heart failure (Stage A)#Management of Metabolic Syndrome|Management of Metabolic Syndrome]] | [[Congestive heart failure treatment of patients at high risk for developing heart failure (Stage A)#Management of Atherosclerotic Disease|Management of Atherosclerotic Disease]] | [[Congestive heart failure treatment of patients at high risk for developing heart failure (Stage A)#Control of Conditions That May Cause Heart Failure|Control of Conditions That May Cause Heart Failure]] | [[Congestive heart failure treatment of patients at high risk for developing heart failure (Stage A)#ACC/AHA Guidelines- Treatment of Patients at High Risk for Developing Heart Failure (Stage A)|ACC/AHA Guideline Recommendations]]
-===[[Congestive heart failure treatment of patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)|Stage B: Patients with Cardiac Structural Abnormalities]]===
+=== [[Congestive heart failure treatment of patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)|Stage B: Patients with Cardiac Structural Abnormalities]] ===
+=== [[Congestive heart failure treatment of patients with current or prior symptoms of heart failure (Stage C)|Stage C: Patients with Current or Prior Heart Failure Symptoms]] ===
-===[[Congestive heart failure treatment of patients with current or prior symptoms of heart failure (Stage C)|Stage C: Patients with Current or Prior Heart Failure Symptoms]]===
+=== [[Congestive heart failure treatment of patients with refractory end-stage heart failure (Stage D)|Stage D: Patients with Refractory End-stage Heart Failure]] ===
-===[[Congestive heart failure treatment of patients with refractory end-stage heart failure (Stage D)|Stage D: Patients with Refractory End-stage Heart Failure]]===
+== [[Congestive heart failure implementation of practice guidelines|Implementation of Practice Guidelines]] ==
-==[[Congestive heart failure implementation of practice guidelines|Implementation of Practice Guidelines]]==
+== [[Congestive heart failure end-of-life considerations|End-Of-Life Considerations]] ==
-==[[Congestive heart failure end-of-life considerations|End-Of-Life Considerations]]==
+== Specific Groups ==
-==Specific Groups==
 [[Congestive heart failure treatment of special populations|Special Populations]] | [[Congestive heart failure treatment of patients who have concomitant disorders|Patients who have concomitant disorders]] | [[Congestive heart failure and obstructive sleep apnea|Obstructive Sleep Apnea in the Patient with CHF]]
-==Guidelines Resources==
-*[http://circ.ahajournals.org/content/112/12/e154.full.pdf The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult] <ref name="pmid16160202">Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG et al. (2005) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=16160202 ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society.] ''Circulation'' 112 (12):e154-235. [http://dx.doi.org/10.1161/CIRCULATIONAHA.105.167586 DOI:10.1161/CIRCULATIONAHA.105.167586] PMID: [http://pubmed.gov/16160202 16160202]</ref>
-*[http://content.onlinejacc.org/cgi/reprint/53/15/1343.pdf 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation] <ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref>
 ==References==
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 {{WikiDoc Sources}}
+[[Category:Cardiology]]
 [[Category:Disease]]
-[[Category:Cardiology]]
 [[Category:Emergency medicine]]
 [[Category:Intensive care medicine]]
+[[Category:Medicine]]
 [[Category:Up-To-Date]]
 [[Category:Up-To-Date cardiology]]