Heart Failure Definition and Symptoms
- Heart failure is a syndrome caused by impaired heart function.
- It is characterised by signs and symptoms such as shortness of breath, fatigue, and leg swelling.
- The heart fails to pump blood effectively, leading to decreased cardiac output.
- Fluid accumulation in the veins and tissues causes congestion.
- Inadequate blood flow can result in ischemia.
- Congestive heart failure is characterised by fluid accumulation in the lungs and other parts of the body.
- Symptoms include peripheral edema, pulmonary edema, and ascites.
- Low pulse pressure can be an early warning sign.
- Left-sided heart failure causes breathing difficulties and fatigue.
- Signs of left ventricular failure include displaced apex beat and gallop rhythm.

Left-Sided Heart Failure
- Left side of the heart pumps oxygen-rich blood to the body.
- Failure of the left side causes blood to back up into the lungs.
- Common signs include increased respiratory rate and labored breathing.
- Pulmonary edema can be indicated by rales or crackles in the lungs.
- Cyanosis may occur in severe cases.

Right-Sided Heart Failure
- Right side of the heart pumps blood to the lungs.
- Failure of the right side causes blood to back up in the veins.
- Signs include peripheral edema and ascites.
- Increased jugular venous distension may be observed.
- Hepatomegaly and splenomegaly can occur.

Diagnosis and Treatment
- Diagnosis is based on symptoms, physical findings, and echocardiography.
- Blood tests and chest x-ray can help determine the underlying cause.
- Treatment depends on severity and may include lifestyle changes.
- Medications like ACE inhibitors, beta blockers, and diuretics are commonly prescribed.
- In severe cases, implanted devices or heart transplantation may be recommended.

Causes, Pathophysiology, and Diagnostic Tools
- Heart failure is a syndrome, not a disease.
- Common causes include coronary artery disease, high blood pressure, atrial fibrillation, valvular heart disease, excess alcohol use, infection, and cardiomyopathy.
- Heart failure is caused by conditions that reduce the efficiency of the heart muscle.
- Long-term activation of neurohormonal systems leads to fibrosis, dilation, and structural changes in the left ventricle.
- No agreed-upon gold standard diagnostic criteria for heart failure.
- N-terminal pro-BNP (NT-proBNP) measurement followed by an ultrasound is recommended in the UK.
- NT-proBNP or BNP measurement followed by an ultrasound is recommended in Europe and the US.
- Echocardiogram (ultrasound) commonly used to support heart failure diagnosis.
- Chest X-rays used to aid in heart failure diagnosis.