Incidence Pathophysiology Classification Causes Diagnosis Assessing Cardiovascular Disability Treatment Messages
Incidence Pathophysiology Classification Causes Diagnosis Assessing Cardiovascular Disability Treatment Messages
Incidence Pathophysiology Classification Causes Diagnosis Assessing Cardiovascular Disability Treatment Messages
Definition
Incidence
Pathophysiology
Classification
Causes
Diagnosis
Assessing cardiovascular disability
Treatment
Messages
Definition
MORTALITY
50% of heart failure patients die
within 5 years from diagnosis.
NEUROHUMORAL
IMBALANCE
• Acute:
– large or complicated MI, acute decompensated chronic HF
• Chronic:
•The upper limit of normal in the non-acute setting for B-type natriuretic peptide (BNP) is
35 pg/mL and for N-terminal pro-BNP (NT-proBNP) it is 125 pg/mL.
• In the acute setting, higher values should be used [BNP , 100 pg/mL, NT-proBNP , 300
pg/mL and mid-regional pro A-type natriuretic peptide (MR-proANP), 120 pmol/L].
• other lab:
Haemoglobin and WBC
Sodium, potassium, urea, creatinine (with estimated
GFR)
Liver function tests (bilirubin, AST, ALT, GGTP)
Lipid profile
Glucose, HbA1c
TSH
Ferritin, TSAT = TIBC
CARDIAC IMAGING
1. Electrocardiogram (ECG):
• Has low specificity.
5.Stress echocardiography
• May
be used for the assessment of inducible ischaemia ,
myocardium viability and low-flow–low-gradient aortic stenosis
6. Cardiac magnetic resonance
• CMR is the gold standard for the measurements of volumes,
mass and EF of both the left and right ventricles.
Stage A At high risk for HF, but without structural or Class I No limitation of physical activity. Ordinary physical
functional abnormality activity does not cause undue fatigue, palpitation or
No signs or symptoms dyspnoea
Stage B Developed structural heart disease strongly Class II Slight limitation of physical activity. Comfortable at
associated with development of HF, but without rest, but ordinary physical activity results in HF
signs or symptoms symptoms
Stage C Symptomatic HF associated with underlying Class III Marked limitation of physical activity. Comfortable at
structural heart disease rest, but less than ordinary activity results in HF
symptoms
Stage D Advanced structural heart disease and marked Class IV Symptoms of HF present at rest. If any physical
symptoms of HF at rest, despite maximal medical activity is undertaken, discomfort is increased
therapy
Treatment
1. Treatment of chronic heart
failure with reduced systolic
function
Goals of therapy:
* Reducing mortality