Cardiology Topic Homepage

Heart Failure

Heart Failure

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:

  • Epidemiology
  • Symptoms and Diagnosis
  • Classification
  • Treatment Options

Enter the Heart Failure Knowledge Centre


References

  1. 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.
  2. Cowie MR, et al. The epidemiology of heart failure. European Heart Journal 1997;18(2):208-225.
  3. Mosterd A, Hoes A. Clinical epidemiology of heart failure. Heart 2007; 93:1137-1146.
  4. Decision Resources. Chronic Heart Failure. Cardium Study No.4 A Pharmacor Service. 2008.
  5. 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.
  6. NICE Clinical Guideline No 108. Chronic Heart Failure. National clinical guideline for diagnosis and management in primary and secondary care. 2010.

Type 2 Diabetes

,

This educational resource contains a range of content developed for healthcare professionals based in Europe who are involved in the treatment and management of type 2 diabetes mellitus. In this section you will find:

Type 2 Diabetes Mellitus Knowledge Centre:
Provides prevalence statistics, treatment options, current diagnostic criteria from WHO and ADA and a section containing the latest guidelines.

Therapy Focus:
Compiles material on emerging insulin/incretin treatment combinations arranged across five informative sections.

'Role of Newer Therapies for Type 2 Diabetes in Combination with Insulin' CME:
EACCME-accredited CME activity consisting of three modules and worth 1 European CME credit (ECMEC).

Clinical Case Studies

MRSA Endocarditis

Infection: Cardiovascular Infections

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.

Vascular Graft Infection

Infection: Cardiovascular Infections

Stephanie J. Dancer BSc, MB BS, MSc, MD, FRCPath, DTM&H, Consultant Microbiologist, NHS Lanarkshire, Scotland

Case History
A 72-year-old man was referred by his general practitioner complaining of intermittent pain in the legs on exercise.

Latest News

Medical Videos

A Guide to the Coronary Angioplasty Procedure
A Guide to the Coronary Angioplasty Procedure
Animation: New therapy prevents heart failure
Animation: New therapy prevents heart failure
3D Medical Animation - Congestive Heart Failure
3D Medical Animation - Congestive Heart Failure
Advances in Dual Antiplatelet Therapy for Acute Coronary Syndrome (ACS)
Advances in Dual Antiplatelet Therapy for Acute Coronary Syndrome (ACS)
The Lead: Time to Abandon LDL Treatment Targets?
The Lead: Time to Abandon LDL Treatment Targets?
A Discussion of Interventional Cardiology and the Procedures Involved
A Discussion of Interventional Cardiology and the Procedures Involved

Recent Drug Updates

Medical Journal Abstracts on Cardiology

The influence of body mass index on outcomes in patients undergoing cardiac surgery: does the obesity paradox really exist?

Tue 17 Mar 2015 -  The influence of body mass index on outcomes in patients undergoing cardiac surgery: does the obesity paradox really exist?

Purpose: Obesity influences risk stratification in cardiac surgery in everyday practice. However, some studies have reported better outcomes in patients with a high body mass index (BMI): this is ...

Distribution of Subcutaneous Fat and the Relationship with Blood Pressure in Obese Children and Adolescents in Shandong, China

Sat 14 Feb 2015 -  Distribution of Subcutaneous Fat and the Relationship with Blood Pressure in Obese Children and Adolescents in Shandong, China

Background: The association between elevated blood pressure (BP) and childhood obesity has been documented in several studies. However, the association between BP and body fat distribution in ...

Clinical Guidelines

Acute heart failure: diagnosing and managing acute heart failure in adults

Oct 2014

This guideline includes important aspects of the diagnosis and management of acute heart failure..

... that are not addressed by the NICE guideline on chronic heart failure (NICE clinical guideline 108). The guideline on chronic heart failure focused on long-term management rather than on the immediate care of someone who is acutely unwell as a result of heart failure.

This guideline covers the care of adults (aged 18 years or older) who have a diagnosis of acute heart failure, have possible acute heart failure, or are being investigated for acute heart failure. It includes the following key clinical areas:
- the role of early natriuretic peptide testing and echocardiography
- the role of specialist management units
- the use of ventilatory support, pharmacological therapy and ultrafiltration
- treatment after stabilisation, including selected surgical interventions and initiation of the pharmacological therapies that are used in the management of chronic heart failure.

2014 ESC Guidelines on the diagnosis and treatment of aortic diseases

Aug 2014

The ESC decided to publish updated guidelines on the diagnosis and treatment of aortic diseases..

... related to the thoracic and abdominal aorta. Emphasis is made on rapid and efficacious diagnostic strategies and therapeutic management, including the medical, endovascular, and surgical approaches, which are often combined. In addition, genetic disorders, congenital abnormalities, aortic aneurysms, and AD are discussed in more detail.

Online CME

Considerations for Individualising Pharmacotherapy

Learn about the complexities of obesity, appropriate use of pharmacotherapy for weight management and how to individualise patient care. EACCME accredited.

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....

Rationale for Lifelong Behavioural 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. EACCME accredited.

Clinical Trials

Renal Sympathetic Denervation by Iberis System in Patients With Uncontrolled Hypertension - Iberis-HTN Registry

Mon 17 Nov 2014

The purpose of this study is to document safety and efficacy of renal sympathetic denervation treatment in subjects with uncontrolled hypertension by using Iberis renal denervation ...

Cryoballoon Ablation in Patients With Longstanding Persistent Atrial Fibrillation (CRYO-LPAF)

Wed 12 Nov 2014

Prospective and explorative clinical study. The objective is to assess the clinical efficacy of pulmonary vein isolation using the Arctic Front Advance cryoballoon in patients with longstanding ...

Back to top