We searched PubMed from June 1, 2016, to Dec 31, 2016 with the terms āheart failureā or ācardiac dysfunctionā or āleft ventricular dysfunctionā, in combination with the terms āguidelinesā, āstatementā, āepidemiologyā, āpathophysiologyā, āneurohormonalā, āgeneticsā, āgeneticā, āsymptomā, āsignā, ādiagnosisā, ālaboratoryā, āironā, āanaemiaā, ākidneyā, ārenalā, ācreatinineā, ānitrogenā, āhepaticā, āliverā, ātransaminasesā, āalbuminā, āsodiumā, āpotassiumā, āchlorideā, āechocardiographyā,
SeminarHeart failure
Introduction
Heart failure is a syndrome characterised by symptoms (such as breathlessness, ankle swelling, and fatigue) and signs (eg, raised jugular venous pressure, pulmonary crackles, and peripheral oedema) caused by structural or functional cardiac abnormalities that lead to elevated intracardiac pressures or a reduced cardiac output at rest or during stress. Heart failure is a leading and increasing cause of morbidity and mortality worldwide. General physicians and family doctors, and emergency physicians in cases of acute heart failure, care for most patients with heart failure.
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Classification
Many clinical classification systems have been used for heart failure, including those based on symptom severityāeg, as assessed by the New York Heart Association functional classification system1āor on disease progression, as staged from A to D in the American College of Cardiology (ACC) and American Heart Association (AHA) guidelines.2 The ACC/AHA guidelines include patients at risk of developing heart failure (stage A) and those with structural heart disease but without signs and symptoms
Epidemiology
Chronic heart failure affects about 2% of the adult population worldwide. The prevalence of heart failure is age-dependent, ranging from less than 2% of people younger than 60 years to more than 10% of those older than 75 years.9, 10, 11, 12 Increased values are found when the definition incorporates patients with asymptomatic left ventricular dysfunction, including an increase to 5Ā·5% in people 60 years or older with systolic dysfunction and an increase to 36Ā·0% in people 60 years or older
Definition
Acute heart failure is increasingly recognised as a distinct disorder with unique pathophysiology, treatments, and outcomes. Acute heart failure can be defined as the new onset or recurrence of symptoms and signs of heart failure, requiring urgent evaluation and treatment and resulting in unscheduled care or hospital admission.1, 111 Although the word acute suggests a sudden onset of symptoms, many patients might have a more subacute course, with gradual worsening of symptoms that ultimately
Conclusions
Heart failure continues to be a leading cause of morbidity and mortality worldwide. Symptoms and signs should be integrated with biomarkers and cardiac-imaging modalities for the diagnosis of heart failure where possible. Prevention of heart failure might be improved by better control of cardiovascular risk factors, including hypertension, possibly by lowering of systolic blood pressure targets in patients at increased risk of cardiovascular events and in those with diabetes, in whom
Search strategy and selection criteria
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