Heart Failure

Heart failure does not mean that the heart has "stopped". It is a clinical syndrome in which the heart has difficulty responding effectively to the needs of the body or this is achieved by increased pressures within the heart.

It can have different causes and different forms, so the assessment is not based on a single examination.

Yes.

Heart failure is not determined by ejection fraction alone. There are patients with symptoms and evidence of heart failure even though the ejection fraction remains normal or relatively preserved.

Diagnosis requires a combination of symptoms, clinical findings and tests.

HFrEF refers to heart failure with reduced ejection fraction.

HFpEF refers to heart failure with preserved ejection fraction.

These are different clinical forms and the diagnosis should not be made only by a number on the ultrasound.

When the pressures on the heart increase, blood circulation to the lungs can be affected and shortness of breath can occur, especially on exertion or in more advanced cases even at rest.

Shortness of breath, however, has many other possible causes and does not in itself mean heart failure.

Fluid retention can cause swelling in the lower extremities in patients with heart failure.

However, leg swelling can have many other causes, such as venous insufficiency, certain medications, or other health problems. It needs to be evaluated in the right clinical context.

The diagnosis is based on the combination of:

history, symptoms, clinical examination, electrocardiogram, echocardiogram and, when necessary, laboratory or other tests.

There is no single test that alone answers all cases.

They are biomarkers that can increase when there is increased pressure or strain on the heart.

They can help investigate possible heart failure, but are not interpreted in isolation. Age, kidney function, heart rate and other factors affect their values.

There is no fixed interval for everyone.

The need for a repeat test depends on the type of heart failure, symptoms, course, changes in treatment and whether a new test is expected to change management.

New or increasing shortness of breath, a significant decrease in strength, rapidly increasing swelling, difficulty breathing when lying down, or a sudden change in general condition need evaluation.

Severe shortness of breath at rest, sudden significant worsening, chest pain, fainting, or severe general malaise require immediate medical evaluation.