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Congestive heart failure (CHF) is a complex clinical syndrome characterized by inefficient myocardial performance, resulting in compromised blood supply to the body. CHF results from any disorder that impairs ventricular filling or ejection of blood to the systemic circulation.
There is an imbalance in human heart failure between vasoconstrictive and vasodilatory factors (nitric oxide, bradykinin, natriuretic peptides). Myocardial stretch (volume, pressure) leads to release of natriuretic peptides from cardiomyocytes to counteract the constrictive effects (see above).
Heart failure is a common and complex clinical syndrome that results from any functional or structural heart disorder, impairing ventricular filling or ejection of blood to the systemic circulation to meet the body's needs. Heart failure can be caused by several different diseases.
CHF is a common disorder worldwide with a high morbidity and mortality rate. With an estimated prevalence of 26 million people worldwide, CHF contributes to increased healthcare costs, reduces functional capacity, and significantly affects quality of life.
In patients with heart failure, the physical examination can provide important prognostic information and is also used to guide both diagnosis and management, including determining the need for inpatient versus outpatient management.
The 2022 heart failure guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to managing patients with heart failure, with the intent to improve quality of care and align with patients' interests.
Eight chapters are dedicated to the differential diagnosis of congestive heart failure, including cardiomyopathies, valvular heart disease, and inflammatory heart disease. A special chapter on the pathology of congestive heart failure is written by Dr. Margaret Billingham.