The Heart
Heart Failure
Heart failure is a clinical syndrome characterized by the heart’s inability to pump blood at a rate sufficient to meet the metabolic demands of the body or to do so only at elevated filling pressures. Contrary to common misconception, heart failure does not imply that cardiac activity has ceased; rather, it reflects impaired ventricular function resulting in inadequate perfusion of tissues and organs. The dysfunction may involve impaired ventricular filling (diastolic dysfunction), impaired ejection (systolic dysfunction), or a combination of both.
The condition typically develops insidiously over time, in contrast to the abrupt onset of a myocardial infarction. Progressive weakening of the myocardium leads to a decline in the heart’s pumping efficiency. Heart failure may affect the left ventricle, the right ventricle, or both. Left-sided heart failure, the more prevalent form, results in inadequate systemic perfusion and pulmonary congestion due to elevated left atrial and pulmonary venous pressures. Right-sided heart failure is characterized by systemic venous congestion secondary to the right ventricle’s inability to propel blood effectively into the pulmonary circulation.
Physiological consequences include pulmonary and systemic venous hypertension, fluid accumulation in the lungs (pulmonary edema), peripheral edema involving the feet, ankles, and lower extremities, and decreased exercise tolerance accompanied by fatigue and dyspnea.
In the United States, heart failure affects an estimated five million individuals and accounts for approximately 300,000 deaths annually. It represents a leading cause of hospitalization among older adults and poses a significant public health burden due to its chronic and progressive nature.
Heart failure is a clinical syndrome characterized by the heart’s inability to pump blood at a rate sufficient to meet the metabolic demands of the body or to do so only at elevated filling pressures. Contrary to common misconception, heart failure does not imply that cardiac activity has ceased; rather, it reflects impaired ventricular function resulting in inadequate perfusion of tissues and organs. The dysfunction may involve impaired ventricular filling (diastolic dysfunction), impaired ejection (systolic dysfunction), or a combination of both.
The condition typically develops insidiously over time, in contrast to the abrupt onset of a myocardial infarction. Progressive weakening of the myocardium leads to a decline in the heart’s pumping efficiency. Heart failure may affect the left ventricle, the right ventricle, or both. Left-sided heart failure, the more prevalent form, results in inadequate systemic perfusion and pulmonary congestion due to elevated left atrial and pulmonary venous pressures. Right-sided heart failure is characterized by systemic venous congestion secondary to the right ventricle’s inability to propel blood effectively into the pulmonary circulation.
Physiological consequences include pulmonary and systemic venous hypertension, fluid accumulation in the lungs (pulmonary edema), peripheral edema involving the feet, ankles, and lower extremities, and decreased exercise tolerance accompanied by fatigue and dyspnea.
In the United States, heart failure affects an estimated five million individuals and accounts for approximately 300,000 deaths annually. It represents a leading cause of hospitalization among older adults and poses a significant public health burden due to its chronic and progressive nature.
