II. Epidemiology
- Lifetime risk: 20% in U.S.
- Prevalence: 5.2 Million with CHF in the United States
- Incidence: 400,000 cases CHF diagnosed per year
- Morbidity: 870,000 hospitalizations (estimates in 2013 approach 1 Million)
- Re-hospitalization rate within 30 days approaches 20%
- Mortality: 200,000 patients die from CHF per year
- CHF costs
- Accounts for 5-10% of all hospital admissions
- Annual U.S. Cost: $38.1 billion ($44.6 billion by 2015)
III. Pathophysiology
- Heart Failure is a syndrome, not a disease
- Heart Failure is a final common pathway
- Maximize treatment of the underlying causes
- Control the causes and prevent end organ damage
IV. Precautions
- Heart Failure is a clinical diagnosis best made by an astute clinician with history and exam
- Labs (e.g. BNP) and diagnostics (e.g. Echocardiogram) should be adjunctive only to confirm and follow the diagnosis
V. Evaluation
VI. Causes
VII. Types
-
Systolic Dysfunction (60-70% of Heart Failure cases)
- Decreased contractility
- Decreased Left Ventricular Ejection Fraction
-
Diastolic Dysfunction (30-40% of Heart Failure cases)
- Decreased compliance
- Decreased filling
- Variable Left Ventricular Ejection Fraction
VIII. Labs
IX. Diagnostics
- See Chest XRay in Congestive Heart Failure
- See Echocardiogram in Congestive Heart Failure
- All CHF patients should undergo Echocardiogram
X. Classification: Congestive Heart Failure
XI. Management
XII. Resources
- American Heart Association CHF Website
XIII. Associated Conditions
- Central Sleep Apnea (60% pretest probability)