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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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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
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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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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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[High-output heart failure].

Jean Regina1, Grégoire Racine1, Antoine Moalic1

  • 1Service de médecine interne et des soins intensifs, Hôpital de Nyon, Groupement hospitalier de l'Ouest lémanique, 1260 Nyon.

Revue Medicale Suisse
|September 9, 2022
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Summary
This summary is machine-generated.

High output heart failure (HOHF) is a complex condition characterized by decreased vascular resistance and increased cardiac output. Early diagnosis and etiology-specific treatment are crucial for managing this often under-diagnosed heart condition.

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Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • High output heart failure (HOHF) presents with diverse causes but shares a common mechanism: reduced systemic vascular resistance.
  • This can lead to increased metabolic demands, neurohormonal activation, and fluid retention, creating a hyperdynamic state.

Purpose of the Study:

  • To define the diagnostic criteria and clinical presentation of high output heart failure.
  • To highlight the importance of identifying HOHF, especially in specific patient populations.

Main Methods:

  • Review of existing literature and clinical definitions of HOHF.
  • Analysis of diagnostic indicators, including elevated cardiac output (cardiac index >4 L/min/m2).

Main Results:

  • HOHF is characterized by a hyperdynamic circulatory state and clinical signs of congestion.
  • A cardiac index exceeding 4 L/min/m2 is a key diagnostic indicator.

Conclusions:

  • HOHF is likely under-diagnosed and warrants active investigation.
  • Obese patients and those with heart failure with preserved ejection fraction (HFpEF) are key populations to consider.
  • Treatment and prognosis are contingent upon identifying the underlying etiology.