Heart Failure is a progressive chronic disorder that results in the inability of the heart to pump blood efficiently to the body’s tissues.
Chronic heart failure is an increasing public health problem; the growing prevalence in industrialised countries means that 1-2% of the adult population of these countries are now thought to have chronic heart failure.1-3 Estimates suggest that the prevalence in Europe, USA and Japan could increase by approximately 16.5% over the next ten years.4
The prevalence of post-myocardial infarction heart failure is less well known as it is difficult to distinguish between pre-existing and incident heart failure. However current estimates suggest that approximately 1 in 5 patients hospitalised with an acute coronary syndrome either present with heart failure or develop heart failure during their hospital stay.5
Many of the signs and symptoms of heart failure are non-specific and vary in severity depending on the disease class. The most common of these are breathlessness, fatigue, exercise intolerance, and fluid retention as evidenced by ankle swelling, peripheral oedema, and an elevated jugular venous pressure.6
Due to the non-specific nature of symptoms, the diagnosis of heart failure can be difficult. Tests can include echocardiogram, ECG, chest X-ray, laboratory tests. Following a positive diagnosis heart failure is classified into functional classes that relate to disease severity.
Management of heart failure involves lifestyle modifications, pharmacological treatment and occasionally surgery. In patients with chronic heart failure, optimal therapy involves treatment with diuretics, ACE inhibitors, certain β-blockers and a mineralocorticoid receptor antagonist.
The Heart Failure Knowledge Centre brings together current information related to chronic heart failure and post-myocardial infarction, including:
Zannad F, et al. Incidence, clinical and etiologic features, and outcomes of advanced chronic heart failure: the EPICAL Study. Journal of the American College of Cardiology 1999; 33(3):734-742.
Cowie MR, et al. The epidemiology of heart failure. European Heart Journal 1997;18(2):208-225.
Mosterd A, Hoes A. Clinical epidemiology of heart failure. Heart 2007; 93:1137-1146.
Decision Resources. Chronic Heart Failure. Cardium Study No.4 A Pharmacor Service. 2008.
Steg PG, Dabbous OH, et al. Determinants and prognostic impact of heart failure complicating acutecoronary syndromes. Observations from the Global Registry of Acute Coronary Events (GRACE). Circulation2004;109:494-9.
NICE Clinical Guideline No 108. Chronic Heart Failure. National clinical guideline for diagnosis and management in primary and secondary care. 2010.
Based on current estimates, the global prevalence of Type 2 diabetes mellitus has increased almost 10 fold since 1985 and is expected to rise to 552 million by 2030,1 and when absolute numbers of people with diabetes are considered, it is South East Asia and the West Pacific that are expected to experience the highest increases in prevalence over the coming years.2
An EACCME accredited CME is available, awarded 1 European CME credits (ECMEC's). Consisting of 3 modules:
A Review of Newer Therapies for Type 2 Diabetes in Combination with Insulin, John Wilding (Chair)
Identifying and Managing the Psychosocial Aspects of Type 2 Diabetes Mellitus, Richard Holt (Faculty)
Potential Role of Newer Therapies for Type 2 Diabetes in Combination with Insulin: Interactive Case Discussion, Bernard Charbonnel (Faculty)
The Type 2 Diabetes Knowledge Centre aims to provide clear and concise information based on current accepted guidelines on the treatment and management of patients with this disease. In addition the Knowledge Centre also provides access to key guidelines and a review of treatment options available.
This EACCME-accredited obesity CME series contains three CME modules, which are ideal for healthcare professionals looking to improve their understanding of obesity as a serious medical illness.
Module 1 – Understanding Obesity
Learn more about obesity as a serious and complex medical illness including comorbidities and complications, the complex factors that influence its development and the cornerstones of an effective weight-management strategy.
Module 3 – Rationale for Lifelong Behaviour Change
Explore the factors affecting maintenance of weight loss, the importance of implementing permanent behaviour changes to prevent weight regain and the components of a successful long-term weight-management strategy.
Christopher D. Pfeiffer, Clinical Fellow, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA Vance Fowler, Associate Professor and Infectious Diseases, Specialist, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
Case History A 64-year-old female presented with three weeks of progressive dyspnoea, nausea and vomiting.
Decisions to start cardiopulmonary resuscitation (CPR), or to decide in advance to issue a "do not attempt (cardiopulmonary) resuscitation" (DNAR) notice have always been a hot topic in clinical medicine. It may have become even more so since a recent (June 2014) court decision. This post discusses some of the issues and legalities around DNAR decisions.
This module describes ECG findings present in cardiomyopathies afflicting young athletes and outlines appropriate steps for further evaluation of these ECG abnormalities. The ECG findings defined as abnormal in athletes...