मैं, अ, मैं 223, अ, मैं 1 poster of heart failure and its management from, अ, Harrison's textbook of, अ, medicine.

I'll create a poster on heart failure and its management using Harrison's textbook. Let me first read the medical library skill, then search for the relevant content.
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Now let me search the library for heart failure content from Harrison's textbook in parallel.
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Harrison's ISBN is 9781265977061. Now let me search for heart failure sections specifically in Harrison's.
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Excellent! I found the key sections. Let me read the main heart failure chapters from Harrison's - block28 has the pathophysiology/diagnosis chapter and the management sections.
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I have rich content. Now let me fetch the key images from Harrison's to include in the poster.
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I now have excellent content. Let me also fetch one more key image - the HFrEF management figure, and read the HFrEF pharmacotherapy section.
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I now have all the content needed from Harrison's. Let me now generate a comprehensive, visually rich poster on heart failure and its management.
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A comprehensive medical education poster titled "HEART FAILURE & ITS MANAGEMENT" based on Harrison's Principles of Internal Medicine 22nd Edition. The poster should be organized in clear sections with a dark navy blue header and clean white background. Section 1 - DEFINITION: Heart failure is a clinical syndrome with symptoms/signs from structural or functional impairment of ventricular filling or ejection. Key features: breathlessness, ankle swelling, fatigue, elevated JVP, pulmonary crackles, peripheral edema. Section 2 - CLASSIFICATION (3 types in colored boxes): - HFrEF: EF < 40% (Heart Failure with Reduced Ejection Fraction) - HFmrEF: EF 40-49% (Mildly Reduced EF) - HFpEF: EF ≥ 50% (Preserved EF) Section 3 - EPIDEMIOLOGY: 6.7 million Americans affected, 56.2 million globally, >600,000 new cases/year in USA. Section 4 - PATHOPHYSIOLOGY: Neurohormonal activation diagram showing RAAS activation, sympathetic nervous system activation, ventricular remodeling leading to progressive cardiac dysfunction. Section 5 - CLINICAL FEATURES (two columns): Symptoms: Dyspnea, orthopnea, PND, fatigue, ankle swelling Signs: Elevated JVP, S3 gallop, pulmonary crackles, peripheral edema, hepatomegaly Section 6 - DIAGNOSIS: BNP/NT-proBNP elevated, Echocardiography (key), CXR (cardiomegaly, pulmonary congestion), ECG changes Section 7 - CHRONIC HFrEF MANAGEMENT - FOUR PILLARS (in colored treatment boxes with arrows showing mortality reduction): 1. ACEi/ARB or ARNI (Sacubitril-Valsartan) - 23% mortality reduction 2. Beta-Blockers (Carvedilol, Bisoprolol, Metoprolol succinate) - 35% mortality reduction 3. MRA (Spironolactone/Eplerenone) 4. SGLT-2 Inhibitors (Empagliflozin/Dapagliflozin) - newest pillar Additional: Diuretics for symptom relief, ICD for SCD prevention, CRT for dyssynchrony Section 8 - ACUTE DECOMPENSATED HF MANAGEMENT: - Typical (Hypertensive): Vasodilators - Normotensive (volume overloaded): IV Diuretics - Pulmonary Edema: O2, NIV, Vasodilators, Diuretics - Low Output: Inotropes, Hemodynamic monitoring - Cardiogenic Shock: Catecholamines, Mechanical circulatory support (IABP, VAD) Section 9 - HFpEF MANAGEMENT: BP control, Diuretics for congestion, Treat comorbidities (AF, obesity, CKD, sleep apnea), SGLT-2i beneficial Footer: Source: Harrison's Principles of Internal Medicine, 22nd Edition (2025) | Chapters 264 & 265 Use professional medical poster design with color-coded sections (blue for definition, green for pharmacotherapy, orange for acute management, purple for HFpEF), icons for each drug class, and clear hierarchy of information. Include a small heart diagram illustration.

यहाँ है आपका Heart Failure & Management का poster, Harrison's Principles of Internal Medicine 22nd Edition (2025) पर आधारित:
Heart Failure & Management Poster

Harrison's से मुख्य Points जो Poster में हैं:

📖 Definition (Chapter 264)

Heart Failure एक complex clinical syndrome है जिसमें structural/functional cardiac abnormality के कारण symptoms आते हैं। Universal definition के लिए दो में से एक होना जरूरी है:
  • Elevated natriuretic peptide levels (BNP/NT-proBNP)
  • Objective evidence of cardiogenic pulmonary/systemic congestion

🏥 Classification

TypeEFFeatures
HFrEF< 40%Systolic dysfunction
HFmrEF40–49%Mildly reduced
HFpEF≥ 50%Diastolic dysfunction

💊 Chronic HFrEF - चार मुख्य Pillars

  1. ARNI (Sacubitril-Valsartan) या ACEi/ARB - 23% mortality ↓
  2. Beta-Blockers (Carvedilol, Bisoprolol, Metoprolol succinate) - 35% mortality ↓
  3. MRA (Spironolactone/Eplerenone)
  4. SGLT-2 Inhibitors (Empagliflozin/Dapagliflozin) - newest pillar

⚡ Acute Decompensated HF (ADHF) Management

Harrison's के Figure 265-2 के अनुसार:
ADHF Management Phenotypes

📊 Mortality Reduction Graph (Harrison's Fig. 265-3)

Mortality Reduction with HF Therapies
यह graph clearly दिखाता है कि ARNI, SGLT-2i सबसे ज़्यादा mortality reduce करते हैं, जबकि oral inotropes और endothelin antagonists harmful हैं।

Source: Harrison's Principles of Internal Medicine, 22nd Edition (2025) - Chapters 264 & 265 by Givertz & Mehra
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