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Related Concept Videos

Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

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Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
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Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

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Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
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Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

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The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
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Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

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Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
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Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

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Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs
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Heart Failure with Preserved Ejection Fraction: Diagnosis and Management.

John D Gazewood1, Patrick L Turner2

  • 1University of Virginia Health System, Charlottesville, VA, USA.

American Family Physician
|November 3, 2017
PubMed
Summary

Heart failure with preserved ejection fraction (HFpEF), or diastolic heart failure, affects nearly half of US heart failure cases. Management focuses on symptom relief with diuretics and treating comorbidities like hypertension and atrial fibrillation.

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Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Heart failure with preserved ejection fraction (HFpEF), also known as diastolic heart failure, accounts for nearly 50% of heart failure cases in the US.
  • It disproportionately affects older individuals and women, stemming from impaired ventricular relaxation and compliance, reducing stroke volume and cardiac output.

Purpose of the Study:

  • To outline the diagnostic criteria and management strategies for heart failure with preserved ejection fraction.
  • To highlight the importance of recognizing HFpEF symptoms and signs for timely diagnosis and intervention.

Main Methods:

  • Diagnosis is suspected based on typical heart failure symptoms and signs, confirmed by echocardiography showing normal ejection fraction with diastolic dysfunction.
  • Natriuretic peptide measurement aids in ambulatory evaluation.
  • Review of multiple clinical trials on treatment efficacy.

Main Results:

  • Medications have limited efficacy, with diuretics being the primary treatment for congestive symptoms.
  • Management involves treating comorbidities such as hypertension, atrial fibrillation (rate control and anticoagulation), and considering revascularization for coronary artery disease.
  • Multidisciplinary team care and exercise may offer benefits.

Conclusions:

  • HFpEF prognosis is similar to heart failure with reduced ejection fraction, influenced by factors like brain natriuretic peptide levels, age, prior myocardial infarction, and diastolic function.
  • Effective management relies on symptom control, comorbidity treatment, and supportive care strategies.