Heart failure

Heart failure is a clinical syndrome caused by structural and/or functional cardiac abnormalities, resulting in a reduced cardiac output and/or elevated intracardiac pressures at rest or during stress. The prevalence is approximately 1–2% of the adult population in developed countries, rising to ≥10% among people > 70 years of age. The most common symptoms are:
  • Shortness of breath on exertion and at rest,
  • asthenia,
  • breathing difficulty in supine position,
  • Cough associated with supine position,
  • abdominal tension,
  • loss of appetite,
  • excessive urination during the night (nocturia) and reduction of that during the day(daytime oliguria),
  • mental confusion and cognitive impairment.

Symptoms may be accompanied by characteristic clinical signs:
  • jugular turgor,
  • hepatomegaly,
  • peripheral edema,
  • pulmonary crackles,
  • wheezing,
  • weight loss (cardiac cachexia),
  • central cyanosis (generalized bluish discoloration of the body),
  • increased heart rate.

Before clinical symptoms become apparent, patients can present with asymptomatic structural or functional cardiac.

Recognition of these precursors is important because they are related to poor outcomes, and starting treatment at the precursor stage may reduce mortality in patients with asymptomatic systolic left ventricular dysfunction.

Demonstration of an underlying cardiac cause is central to the diagnosis of heart failure.
Main causes are:
  • myocardial abnormality
  • valves abnormalities
  • pericardium abnormalities
  • endocardium abnormalities
  • heart rhythm abnormalities

Pathophysiological assessment is crucial to identify specific therapeutic opportunities.

Many patients will have several different comorbidities (i.e. angina and coronary artery disease, diabetes mellitus, iron deficiency and anaemia, lung kidney dysfunction, hypertension, hyperlipidaemia, gout and arthritis, obesity, sleep disturbance and sleep-disordered breathing, valvular heart disease)

ProKardia, through a team of specialists, offers an assistance aimed to ensure:
  • prior diagnosis
  • pathophysiological assessment through specific diagnostic tests
  • management of comorbidities
  • risk stratification
  • customized monitoring systems
  • therapeutic management and prevention

Reference: European Heart Journal (2016) 37, 2129–2200

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