Heart failure
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"heart failure" AND "management"
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heart failure pathophysiology diagram
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This is a comprehensive medical student overview of heart failure. Here's a quick summary of what's covered:
Structure of the guide:
- Definition & Types — HFrEF vs HFpEF vs high-output; ACC/AHA Stages A–D; NYHA Classes I–IV
- Pathophysiology — LV remodeling as the core process; the SNS + RAAS vicious cycle (with diagram); cellular changes in calcium handling, β-receptor remodeling, apoptosis; the four determinants of cardiac performance (preload, afterload, contractility, HR)
- Clinical Features — left-sided vs right-sided symptoms and signs; S₃ gallop as hallmark
- Diagnosis — ECG, CXR, echo (key test), BNP/NT-proBNP, targeted labs, indications for biopsy
- Management:
- Non-pharmacological (salt/fluid restriction, exercise, monitoring)
- "Fantastic Four" GDMT for HFrEF: ACE-I/ARNi + β-blocker + MRA + SGLT2 inhibitor — all with mortality benefit
- HFpEF management (SGLT2i now evidence-based as of 2022–2025)
- Devices: ICD, CRT, LVAD, transplant
- What doesn't improve mortality: diuretics, digoxin (symptom relief only)
A recent 2025 meta-analysis (PMID 40884036, Circulation) confirmed SGLT2 inhibitors reduce events even in patients hospitalized for HF, reinforcing their guideline-level status.
Let me know if you'd like to go deeper on any specific area — e.g., acute decompensated HF management, specific drug mechanisms, or ECG/imaging interpretation in HF.
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