Chronic heart failure (symptoms, diagnostic, treatment)

1. Big picture

Chronic heart failure is a clinical syndrome in which the heart cannot maintain adequate cardiac output and/or can do so only with abnormally high filling pressures. Clinically, think of two consequences:

Pump failure → low forward output → fatigue, weakness, cold extremities, renal hypoperfusion, tachycardia.

Congestion → high venous pressure behind the failing ventricle → pulmonary congestion/dyspnea if left-sided; leg edema, hepatomegaly, ascites if right-sided.

For the exam, the examiner wants you to recognize the syndrome from dyspnea + edema + fatigue, confirm it with natriuretic peptides and echocardiography, classify by left ventricular ejection fraction (LVEF), and treat chronic heart failure with mortality-reducing drugs, not only diuretics.

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