Heart Failure : A Clinical Syndrome Characterized By Structural Or Functional Impairment Of Ventricular

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TERMINOLOGY
CLINICAL CLARIFICATION
• Heart failure is a clinical syndrome characterized by structural or functional impairment of ventricular filling or ejection of blood resulting in insufficient perfusion to meet metabolic demands; most commonly results from impaired left ventricular myocardial function; cardinal manifestations include edema, dyspnea, and Fatigue4•5
CLASSIFICATION
• Classification by American College of Cardiology Foundation/American Heart Association {based on structure and progression of disease) 4 o StageA
- At high risk for heart Failure without structural heart disease or symptoms
- Hypertension and lipid disorders to be controlled
- Obesity, diabetes mellitus, tobacco use, and known cardiotoxic agents, should be controlled or avoided o Stage B
- Structural heart disease without signs and symptoms of heart failure
- In patients with a history of myocardial infarction and reduced ejection fraction
- Preventive medications o Stage C
- Structural heart disease with prior or current symptoms of heart failure
- Nonpharmacological and pharmacological interventions o StageD
- Refractory heart failure requiring specialized interventions
- Advanced heart failure
• Classification by New York Heart Association (based on symptom severity) 4 o Class I
- Heart disease with no symptoms or limitations on physical activity o Class II (mild)
- Symptoms of heart failure during ordinary activity o Class Ill (moderate)
- Symptoms of heart failure with minimal exertion o

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