2021 Sep 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–.
Heart failure is a complex clinical syndrome that results from a functional or structural heart disorder impairing ventricular filling or ejection of blood to the systemic circulation. It is by definition a failure to meet the systemic demands of circulation. Heart failure remains a highly prevalent disorder worldwide with a high morbidity and mortality rate. It has an estimated prevalence of 26 million people worldwide and contributes to increased healthcare costs worldwide. Multiple different diseases can cause heart failure. The etiology of heart failure varies the treatment plan to some degree; however, most of the treatment recommendations are based on the presence of heart failure alone, regardless of the cause.
Classification of heart failure is based on symptoms and calculated left ventricular ejection fraction (LVEF). Heart failure due to left ventricular dysfunction is categorized into heart failure with reduced ejection fraction (HFrEF), heart failure with preserved ejection fraction (HFpEF), and heart failure with mid-range ejection fraction (HFmrEF). The latter may consist of mixed left ventricular dysfunction (a combination of systolic and diastolic heart failure). The definition of HFrEF has varied among different studies and guidelines but is generally defined as an ejection fraction (EF) of less than 40%. Heart failure with preserved ejection fraction (HFpEF) is generally defined as heart failure with an EF of greater than 50%. HFmrEF is defined as heart failure with an EF of 40% to 50%.
Heart failure can severely decrease the functional capacity of a patient and increase mortality risk. It is imperative to diagnose and effectively treat the disease to prevent recurrent hospitalizations, improve quality of life, and enhance patient outcomes. The treatment of heart failure requires a multifaceted approach involving patient education, optimal medical regimen to improve cardiac contractility, and prevention/limitation of exacerbations. An interprofessional team approach is warranted to optimize patient care.