Dariusz Korczyk and Gerry Kaye - Fast Facts: Heart Failure

Second edition

Declaration of Independence

This book is as balanced and as practical as we can make it.

Ideas for improvement are always welcome:

Fast Facts: Heart Failure

First edition 2012; reprinted 2013, 2016

Second edition June 2017

Text 2017 Dariusz Korczyk, Gerry Kaye

2017 in this edition Health Press Limited

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Oxford OX14 3LN, UK

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ISBN 978-1-910797-32-7

Korczyk D (Dariusz)

Fast Facts: Heart Failure/

Dariusz Korczyk, Gerry Kaye

Medical illustrations by Dee McLean, London,

and Annamaria Dutto, Beverley, UK.

Typesetting by Thomas Bohm, User Design, Illustration and Typesetting, UK.

Printed in the UK with Xpedient Print.

Afterload: the amount of hemodynamic pressure peripheral vascular resistance downstream from the heart

Amyloidosis: systemic illness with uncontrolled production and organ deposition of abnormal protein

BNP: type B natriuretic peptide

Cachexia: loss of weight with muscle atrophy, fatigue, weakness and significant loss of appetite as a result of chronic illness

CAD: coronary artery disease

Compensated heart failure: heart failure with sufficient cardiac output maintained by physiological compensatory mechanisms

Contractile reserve: measure of the myocardiums ability to increase its contractility with stress (exercise or dobutamine)

Cor pulmonale: failure of the right side of the heart due to long-term high blood pressure in the pulmonary arteries and right ventricle

CRT: cardiac resynchronization therapy (CRT-P, with pacemaker; CRT-D, with pacemaker and defibrillator)

Decompensated heart failure: heart failure with clinical signs of fluid overload or low-output state despite compensatory mechanisms

EF: ejection fraction the percentage of blood pumped from the ventricles with each heart beat

HCM: hypertrophic cardiomyopathy

HFmrEF: heart failure with mid-range ejection fraction (4049%)

HFpEF: heart failure with preserved (or normal) ejection fraction ( 50%)

HFrEF: heart failure with reduced ejection fraction (< 40%)

Hypovolemia: intravascular volume loss (due to, for example, bleeding, dehydration, fluid loss)

ICD: implantable cardiac defibrillator

Inotropic: increasing the strength of myocardial contraction

Ischemic heart disease: cardiac disease resulting from CAD

LV: left ventricle/ventricular

LVEF: left ventricular ejection fraction

LVH: left ventricular hypertrophy

MET: metabolic equivalent of task; defined as the ratio of metabolic rate during a specific physical activity to a reference metabolic rate. (MET values range from 0.9 [sleeping] to 18 [running at 17.5 km/hour])

MI: myocardial infarction

NYHA: New York Heart Association

Preload: passive filling of the heart

OSA: obstructive sleep apnea

RAAS: reninangiotensinaldosterone system

RV: right ventricle/ventricular

Vasoconstriction: active narrowing of the blood vessels (arteries) in response to a trigger

Now that we have a better understanding of the mechanisms and outcomes of heart failure (HF), effective new treatments from drugs to surgery to devices are revolutionizing both outcome and wellbeing in patients with the condition. Nevertheless, it remains a serious public health problem, as the number of patients requiring treatment continues to increase along with the associated costs to healthcare systems and society.

This book is an ideal introduction to HF for primary care providers, cardiac nurses, junior hospital doctors, medical students and cardiology trainees looking for a clear approach to patient management in a highly readable form. We start with new definitions of HF (different types of HF require different treatments), then provide the latest thinking on mechanisms and clinical stages, underlying causes and the assessment and management of comorbidities. This is followed by simple diagnostic criteria and a comprehensive overview of investigations.

The management chapters focus on the importance of self-care education and healthy lifestyle choices, together with the latest recommendations for pharmacological treatment, device therapy and cardiac surgery. As well as the first-line angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta-blockers and diuretics that have been central to HF therapy for more than 20 years, the advent of a first-in-class angiotensin-receptor/neprilysin inhibitor is an indication of the ongoing innovation in this rapidly moving field, as the final chapter on developments also shows.

We have distilled a lot of complex information, and used diagrams, algorithms and pull-out tables to make it as practical and digestible as possible, with key points and references for further reading at the end of each chapter. Furthermore, you can quickly test your knowledge after reading this book by taking our FastTest at fastfacts.com.