Chapter 34
Heart Failure
A syndrome, not a single disease
What is Heart Failure?
Heart failure (HF) is a complex clinical syndrome resulting from any cardiac disorder that impairs the ventricle's ability to deliver adequate blood to metabolizing tissues at rest or during activity. Once called 'congestive heart failure,' the broader term 'heart failure' is now used because not all patients present with fluid overload.
HF is superimposed on an underlying cause -- it is NOT an independent diagnosis. Coronary artery disease causes about two-thirds of systolic dysfunction. The cardinal manifestations are dyspnea and fatigue. HF is the only major cardiovascular disorder still increasing in incidence and prevalence.
The Numbers
HF affects ~5 million Americans (500,000 new cases/year), rising to 6-10% over age 65. Mortality is 5-10% annually with mild symptoms and 30-40% in advanced disease. It accounts for ~20% of hospitalizations over age 65.
π βHF: complex syndrome; ventricle cannot deliver adequate blood. Not independent diagnosis; CAD causes ~2/3 of systolic dysfunction. ~5 million Americans; mortality 5-10% mild, 30-40% advanced. Only CV disorder increasing in prevalence.β