Heart Failure

Heart Failure is...

  • Inability of the heart to pump adequate amounts of blood to meet the body's metabolic demands
  • End stage of all heart diseases
  • Accounts for 5 in 1000 hospital admission each year in the UK


  • Systolic HF - inability of the heart to contract efficiently to eject adequate volumes of blood to meet the body metabolic demand [most common].
  • Diastolic HF - reduction in the heart compliance resulting in compromised ventricular filling and therefore ejection [pericardial disease, restrictive cardiomyopathy, tamponade]
  • Left HF -  inability of the left ventricle to pump adequate amount of blood leading to pulmonary circulation congestions and pulmonary edema. Usually results in RHF due to pulmonary hypertension.
  • Right HF -  inability of the right ventricle to pump adequate amount of blood leading to systemic venous congestion, therefore peripheral edema and hepatic congestion and tenderness.
  • Congestive HF -  failure of both right and left ventricles, which is more common.
  • Low-output HF -  heart failure resulting from reduced cardiac output [Most common]
  • High-output HF -  heart failure that occurs in normal or high cardiac output due to metabolic demand and supply mismatch, either due to reduced blood oxygen carrying capacity [Anemia] or increase body metabolic demand [thyrotoxicosis]
  • Acute HF -  acute onset of symptom presentation usually due to acute event [MI, persistent arrhythmia, Mechanical event (ruptured valve, ventricular aneurysm)]
  • Chronic HF - slow symptoms presentation usually due to slow progressive underlying disease [CAD, HTN etc…]
  • Acute-on-chronic; acute deterioration of a chronic condition, usually following an acute event [anemia, infections, arrhythmias, MI]

Causes of HF

Ischemic heart disease
Valvular disease
Pericardial disease
  • Bradycardia
  • Tachycardia
  • Atrio-ventricular miss-match due to Atrial or ventricular arrhythmia
  • Congestive ‘dilated’
  • Hypertrophic
  • Restrictive
Severe Anemia
Pulmonary hypertension- Pulmonary pathologies


IHD -  infarction causes impaired ventricular function, therefore reduced contractility function and HF. IHD are the most common cause of HF along with HTN
HTN -  increase strain on the heart, since the heart have to pump blood against a high afterload, leading to hypertrophy which increase the chances of arrhythmias. The heart would eventually gets too big for the coronary system to perfuse leading to IHD and compromised ventricular function
Cardiomyopathy -  disease of the heart muscle that is not secondary to IHD $(function(){ var pertama = $('#herb-dict .herblist li:first-child').attr('class'); $('#herb-dict .herblist li.'+pertama).show(); $('#herb-dict .alphlist li#'+pertama+' a').addClass('active'); $('#herb-dict .alphlist li a').click(function(){ var target = $(this).attr('rel') $('#herb-dict .herblist li').hide(); $('#herb-dict .herblist li.'+target).show(); $('#herb-dict .alphlist li a').removeClass('active'); $(this).addClass('active'); }); });