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.
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:
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.
The Anti-Infectives Knowledge Network – Clostridium difficile infections (AIKN-CDI), an initiative by Astellas Pharma EMEA, shares the expertise and experience of thought leaders in the area of anti-infectives.
Recent content updates include:
Data presentations from the 35th International Symposium on Intensive Care and Emergency Medicine (ISICEM), held in Brussels, Belgium 17–20 March 2015
Data from the largest ever European clinician consensus report on Clostridium difficile infection
Updates from the European Commission following the event hosted by CDI Europe and the European Hospital and Healthcare Federation (HOPE) on healthcare-associated infections and Clostridium difficile infection
Also available – interactive annotated treatment guidelines for the management of Clostridium difficile infection.
Please remember to return often to read updated news, clinical insights, and essential information from the latest anti-infectives congresses.
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 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.
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.
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....
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.