Heart Failure

Abstract

Congestive heart failure (CHF) is a major health problem in the United States with a prevalence that has been increasing and a mortality rate that remains high, even as adverse outcomes from other forms of cardiovascular disease have declined. In a critically ill patient, cardiac failure is an ominous sign that requires prompt recognition and aggressive management. Cardiac failure can be acute or more subtle in character, even as a chronic disease process. Heart failure can involve the right heart or left heart, or it can be biventricular in character, and it can occur during diastole or systole. Diastolic left ventricular failure can be very difficult to recognize and diagnose. The degree of valvular dysfunction associated with cardiac failure can vary even in an individual patient, depending on the status of ventricular function and the intravascular volume of the patient.