Heart Failure

Definitions (Braunwald’s Heart Disease, 11th ed., 2019)

  • Failure of heart to pump blood forward at rate sufficient to meet metabolic demands of peripheral tissues, or ability to do so only at abnormally high cardiac filling pressures
  • Low output (↓ cardiac output) vs. high output (↑ stroke volume ± ↑ cardiac output)
  • Left-sided (pulmonary edema) vs. right-sided (↑ JVP, hepatomegaly, peripheral edema)
  • Backward (↑ filling pressures, congestion) vs. forward (impaired systemic perfusion)
  • Systolic (inability to expel sufficient blood) vs. diastolic (failure to relax and fill normally)
  • Reduced (HFrEF, EF <40%), EF 40–49%), & preserved (HFpEF, EF >50%); combination of systolic and diastolic dysfxn may occur regardless of EF