576 Predicting which patients with symptoms and signs of heart failure require an echocardiogram

2005 ◽  
Vol 4 (1) ◽  
pp. 129-129
Keyword(s):  
Heart Failure ◽  
Symptoms And Signs

scholarly journals Pulmonary Congestion Assessment in Heart Failure: Traditional and New Tools

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1306
Author(s):  
Filippo Pirrotta ◽  
Benedetto Mazza ◽  
Luigi Gennari ◽  
Alberto Palazzuoli
Keyword(s):  
Heart Failure ◽  
Adverse Outcome ◽  
Volume Overload ◽  
Pulmonary Congestion ◽  
X Ray ◽  
Persistent Symptoms ◽  
Biochemical Evaluation ◽  
Cardiac Filling ◽  
Symptoms And Signs

Congestion related to cardiac pressure and/or volume overload plays a central role in the pathophysiology, presentation, and prognosis of heart failure (HF). Most HF exacerbations are related to a progressive rise in cardiac filling pressures that precipitate pulmonary congestion and symptomatic decompensation. Furthermore, persistent symptoms and signs of congestion at discharge or among outpatients are strong predictors of an adverse outcome. Pulmonary congestion is also one of the most important diagnostic and therapeutic targets in chronic heart failure. The aim of this review is to analyze the importance of clinical, instrumental, and biochemical evaluation of congestion in HF by describing old and new tools. Lung ultrasonography (LUS) is an emerging method to assess pulmonary congestion. Accordingly, we describe the additive prognostic role of chest ultrasound with respect to traditional clinical and X-ray assessment in acute and chronic HF setting.

Heart failure in an elderly population

2001 ◽  
Vol 11 (4) ◽  
pp. 311-321
Author(s):  
DN Carmichael ◽  
Michael Lye
Keyword(s):  
Heart Failure ◽  
Treatment Options ◽  
Clinical Syndrome ◽  
Point Of View ◽  
Diagnostic Challenge ◽  
The Common ◽  
Characteristic Features ◽  
The Many ◽  
Neuroendocrine Activation ◽  
Symptoms And Signs

Heart failure has been defined in many ways and definitions change over time. The multiplicity of definitions reflect the paucity of our understanding of the primary underlying physiology of heart failure and the many diseases for which heart failure is the common end-point. Fundamentally, heart failure represents a failure of the heart to meet the body’s requirement for blood supply for whatever reason. It is thus a clinical syndrome with characteristic features – not a single disease in its own right. The syndrome includes symptoms and signs of organ underperfusion, fluid retention and neuroendocrine activation. The syndrome arises from a range of possible causes of which ischaemic heart disease is the commonest. From the point of view of a clinician, the underlying pathology will determine treatment options and prognosis. The extensive range of possible aetiologies present a diagnostic challenge both to correctly identify the syndrome amongst all other causes of dyspnoea and to identify the aetiology, allowing optimization of treatment.

scholarly journals A profile of heart failure patients in a tertiary care centre in Eastern India

2016 ◽  
Vol 5 (1) ◽  
pp. 216
Author(s):  
Biswajit Majumder ◽  
Yatindra Mohan Bahuguna ◽  
Sharmistha Chatterjee
Keyword(s):  
Heart Failure ◽  
Age Of Onset ◽  
Tertiary Care ◽  
Epidemiological Data ◽  
Western Country ◽  
Eastern India ◽  
Tertiary Care Centre ◽  
Heart Failure Patients ◽  
Epidemiological Profile ◽  
Symptoms And Signs

Background: Epidemiological data regarding profile of heart failure in India is lacking. So this study was done to assess the epidemiological profile of heart failure patients in eastern India. Aim of the study was to assess the epidemiological profile of heart failure patients in this part of country.Methods: Total 1000 outdoor and indoor patients presented with symptoms and signs of heart failure according to Framingham criteria were studied.Results: Age of onset of HF is lower than western country. IHD is the commonest cause of HF. Diabetes and hypertensions are important risk factors.Conclusions: Earlier detection and treatment of hypertension and diabetes mellitus might have greater impact in reducing the burden of HF in this part of country.

scholarly journals Risk Stratification for Sudden Cardiac Death in Heart Failure

2019 ◽  
Vol 5 (1 (P)) ◽  
pp. 1
Author(s):  
Hendry Purnasidha Bagaswoto
Keyword(s):  
Heart Failure ◽  
Sudden Cardiac Death ◽  
Risk Stratification ◽  
Cardiac Death ◽  
Clinical Syndrome ◽  
Pump Failure ◽  
Failure Risk ◽  
Clinical Challenge ◽  
Symptoms And Signs

Heart failure (HF) is a complex clinical syndrome in which structural / functional myocardial abnormalities result in symptoms and signs of hypoperfusion and/or pulmonary or systemic congestion at rest or during exercise. More than 80% of deaths in patients with HF recognize a cardiovascular cause, with most being either sudden cardiac death (SCD) or death caused by progressive pump failure. Risk stratification of SCD in patients with HF represents a clinical challenge. This review will give an update of current strategies for SCD risk stratification in HF.

Understanding the pharmacology of heart failure

2021 ◽  
Vol 3 (10) ◽  
pp. 404-410
Author(s):  
Jamshid Easa ◽  
Najma Easa ◽  
Jacob Chappell ◽  
David Warriner
Keyword(s):  
Heart Failure ◽  
Water Retention ◽  
Healthcare Systems ◽  
Physical Symptoms ◽  
Clinical Syndrome ◽  
Western World ◽  
Significant Burden ◽  
Downward Spiral ◽  
Ventricular Filling ◽  
Symptoms And Signs

Heart failure (HF) is a common clinical syndrome with ever-increasing prevalence in the Western world. It is associated with extensive morbidity and mortality, as well as being a significant burden on global healthcare systems. It is due to impairment of ventricular filling or contraction, resulting in a constellation of physical symptoms and signs, primarily due to salt and water retention. An understanding of the pharmacological options to manage the condition is imperative to quickly alleviate symptoms and avert a rapidly progressive downward spiral, improving not only quality but also quantity of life.

Cardiac Iron Overload Causes Clinically Evident Heart Failure and Arrhythmia in Sickle Cell Anemia Patients: Evidence From Three Cases

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4846-4846
Author(s):  
Bhakti P. Mehta ◽  
Vasilios Berdoukas ◽  
Mammen Puliyel ◽  
Adam Bush ◽  
Thomas Hofstra ◽  
...  
Keyword(s):  
Heart Failure ◽  
Iron Overload ◽  
Sickle Cell ◽  
Research Funding ◽  
Chelation Therapy ◽  
Liver Iron ◽  
Cardiac Iron ◽  
Cardiac Iron Overload ◽  
Clinical Heart Failure ◽  
Symptoms And Signs

Abstract Abstract 4846 Transfusional iron overload is associated with poor outcomes in sickle cell disease (SCD). Unlike in thalassemia major (TM), there is no evidence that the iron overload per se causes morbidity in SCD. We present two patients with clear evidence of heart failure and arrhythmia secondary to transfusion induced cardiac iron overload, whose symptoms and signs completely resolved after a short period of intensive iron chelation. We studied 134 patients with SCD with magnetic resonance imaging (MRI). Over 50% of patients with TM and 70% of patients with transfusion dependent Diamond Blackfan Anemia demonstrate cardiac iron overload. We reviewed 472 MRIs in 134 patients with SCD. The median liver iron concentration (LIC) was 10.2 mg/g dry weight (dw). Ten percent of the patients had liver iron > 35mg/g dw. Three (2.2%) demonstrated cardiac iron overload. Patient 1 is now 27 years old and began transfusions at the age of 15 years because of pulmonary hypertension. The first MRI performed at the age of 22 years showed LIC >50 mg/g dw and a cardiac R2* of 128 sec−1 (T2* 7.8 ms) that indicates severe cardiac iron load. At this time she was changed from deferasirox to continuous infusion of desferrioxamine. After 6 months the LIC was 47 mg/g dw and her cardiac R2* was 123sec−1 (T2* 8.1ms). She had dyspnea on mild exertion, ankle edema, and orthopnea. Her left ventricular ejection fraction (LVEF) by MRI at that time was 45%. She started intensive chelation therapy with deferiprone (on compassionate basis) 100mg/kg/day and deferasirox 40mg/kg/day. Her symptoms and signs of clinical heart failure resolved within two months. She remains asymptomatic. After 7 months cardiac R2* is 88 sec−1 (T2*11.3ms) with an LVEF of 55% and LIC of 36 mg/g dw. Patient 2 is now 32 years of age. She started regular blood transfusions at the age of 9 years. Her first MRI at the age of 27 years showed a LIC of >60 mg/g dw and no evidence of cardiac iron overload with a cardiac R2* of 29 sec−1(T2* 34.9ms) with an LVEF of 61%. After 2.5 years her cardiac R2* was 68 sec−1 (T2* 14.7 ms) with an LVEF of 65.7% and 18 months later it was 123 sec−1(T2* 8.1 ms) with an LVEF of 72%. She developed significant arrhythmias coincident with her rapid cardiac iron loading. She was started on compassionate use deferiprone and deferoxamine, with which she is poorly compliant. Repeat cardiac MRI showed a worsening of cardiac iron with R2* of 204 sec−1 (T2* 4.9ms) after 8 months with an improved LVEF of 72%. She currently continues of her regular transfusions and deferiprone and is awaiting repeat MRI. Her LVEF improved while on the chelation therapy despite the deterioration in her cardiac iron content. This is consistent with our observation that LVEF tends to improve even with intermittent chelation although the cardiac iron may not decrease. Patient 3 died of numerous complications of SCD at the age of 19 years. She had started transfusions at the age of 10 years, because of a cerebrovascular accident. At the age of 14 years her first abdominal MRI demonstrated a LIC of 12.8 mg/g dw. She had her first cardiac MRI at the age of 16 years which showed no evidence of cardiac iron with a R2* of 30 sec−1 (T2* 32.7ms), which worsened to 57 (T2* 17.4ms) at the age of 17, reflecting a small but rapid increase in cardiac iron. Patient 1 and 2 demonstrate that transfusional iron overload can directly cause life threatening complications in patients with SCD. Patient 1 in particular, was in overt clinical heart failure that responded dramatically to intensification of chelation therapy. These data underscore the importance of direct measurement of tissue iron concentrations and points out that though uncommon, cardiac iron overload can occur in patients with sickle cell anemia with serious consequences. Disclosures: Berdoukas: ApoPharma Inc.: Consultancy. Carson:ApoPharma Inc.: Honoraria; Novartis Inc: Speakers Bureau. Wood:Cooleys Anemia Foundation: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Ferrokin Biosciences: Consultancy; Novartis: Research Funding. Coates:Novartis Inc: Speakers Bureau.

scholarly journals Effects of a mindfulness-based intervention on symptoms and signs in chronic heart failure: A feasibility study

2017 ◽  
Vol 17 (1) ◽  
pp. 54-65 ◽  
Author(s):  
Jonna Norman ◽  
Michael Fu ◽  
Inger Ekman ◽  
Lena Björck ◽  
Kristin Falk
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Usual Care ◽  
Feasibility Study ◽  
Nyha Class ◽  
Symptom Burden ◽  
Heart Association ◽  
Walking Distance ◽  
Nyha Classification ◽  
Symptoms And Signs

Aims: Despite treatment recommended by guidelines, many patients with chronic heart failure remain symptomatic. Evidence is accumulating that mindfulness-based interventions (MBIs) have beneficial psychological and physiological effects. The aim of this study was to explore the feasibility of MBI on symptoms and signs in patients with chronic heart failure in outpatient clinical settings. Methods: A prospective feasibility study. Fifty stable but symptomatic patients with chronic heart failure, despite optimized guideline-recommended treatment, were enrolled at baseline. In total, 40 participants (median age 76 years; New York Heart Association (NYHA) classification II−III) adhered to the study. Most patients ( n=17) were randomized into MBI, a structured eight-week mindfulness-based educational and training programme, or controls with usual care ( n=16). Primary outcome was self-reported fatigue on the Fatigue severity scale. Secondary outcomes were self-reported sleep quality, unsteadiness/dizziness, NYHA functional classification, walking distance in the six-minute walk test, and heart and respiratory rates. The Mann–Whitney U test was used to analyse median sum changes from baseline to follow-up (week 10±1). Results: Compared with usual care (zero change), MBI significantly reduced the self-reported impact of fatigue (effect size −8.0; p=0.0165), symptoms of unsteadiness/dizziness ( p=0.0390) and breathlessness/tiredness related to physical functioning (NYHA class) ( p=0.0087). No adverse effects were found. Conclusions: In stable but symptomatic outpatients with chronic heart failure, MBI alleviated self-reported symptoms in addition to conventional treatment. The sample size is small and further studies are needed, but findings support the role of MBI as a feasible complementary option, both clinically and as home-based treatment, which might contribute to reduction of the symptom burden in patients diagnosed with chronic heart failure.

Overview of pericardial syndromes

ESC CardioMed ◽  
2018 ◽  
pp. 1561-1563
Author(s):  
Michael Arad ◽  
Yehuda Adler
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Pericardial Effusion ◽  
Acute Pericarditis ◽  
Pericardial Disease ◽  
Pericardial Diseases ◽  
Pericardial Syndromes ◽  
Work Up ◽  
Systemic Condition ◽  
Symptoms And Signs

Pericardial diseases manifest as a part of a systemic condition or in isolation. The clinical presentation is driven by inflammation (i.e. pericarditis), excess fluid accumulation (pericardial effusion), or pericardial stiffening (constriction). Corresponding symptoms and signs may include pain, stigmata of systemic inflammation, atrial arrhythmia, haemodynamic compromise, or chronic heart failure. Pericardial tumours and space-occupying lesions are uncommon and may be incidentally detected or present as one of the above-mentioned forms of pericardial disease. Aetiological work-up is usually unnecessary in acute pericarditis but is indicated in the incessant/chronic form and to exclude bacterial infection. Pericardial effusions need to be investigated when large and promptly evacuated when associated with haemodynamic compromise. The hallmark of constrictive physiology is ventricular interdependence. It is important to distinguish transient constriction and to treat inflammation according to aetiology prior to making a decision on surgical relief by pericardiectomy.

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