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Heart failure (HF) is a condition in which a problem with the structure or function of the heart impairs its ability to supply sufficient blood flow to meet the body’s needs.[1] It should not be confused with cardiac arrest (see Terminology, below).
Common causes of heart failure include myocardial infarction and other forms of ischemic heart disease, hypertension, valvular heart disease and cardiomyopathy.[2] Heart failure can cause a large variety of symptoms such as shortness of breath (typically worse when lying flat, which is called orthopnea), coughing, ankle swelling and reduced exercise capacity. Heart failure is often undiagnosed due to a lack of a universally agreed definition and challenges in definitive diagnosis. Treatment commonly consist of lifestyle measures (such as decreased salt intake) and medications, and sometimes devices or even surgery.
Heart failure is a common, costly, disabling and deadly condition.[2] In developing countries, around 2% of adults suffer from heart failure, but in those over the age of 65, this increases to 6—10%.[2][3] Mostly due to costs of hospitalisation, it is associated with a high health expenditure; costs have been estimated to amount to 2% of the total budget of the National Health Service in the United Kingdom, and more than $35 billion in the United States.[4][5] Heart failure is associated with significantly reduced physical and mental health, resulting in a markedly decreased quality of life.[6][7] With the exception of heart failure caused by reversible conditions, the condition usually worsens over time. Although some patients survive many years, progressive disease is associated with an overall annual mortality rate of 10%.[8]
Heart failure is a global term for the physiological state in which cardiac output is insufficient for the body’s needs.
This may occur when the cardiac output is low (often termed “congestive heart failure”).[9]
In contrast, it may also occur when the body’s requirements are increased, and demand outstrips what the heart can provide, (termed “high output cardiac failure”) [10]. This can occur in the context of severe anemia, Gram negative septicaemia, beriberi (vitamin B1/thiamine deficiency), thyrotoxicosis, Paget’s disease, arteriovenous fistulae or arteriovenous malformations.
Fluid overload is a common problem for people with heart failure, but is not synonymous with it. Patients with treated heart failure will often be euvolaemic (a term for normal fluid status), or more rarely, dehydrated.
Doctors use the words “acute” to mean of rapid onset, and “chronic” of long duration. Chronic heart failure is therefore a long term situation, usually with stable treated symptomatology.
Acute decompensated heart failure, which should just describe sudden onset HF, is also used to describe exacerbated or decompensated heart failure, referring to episodes in which a patient with known chronic heart failure abruptly develops symptoms.[citation needed]
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