Does my patient have heart failure?

Abstract

Heart failure (HF) is a common entity in the world with a global prevalence of 1-2% of the general probability that increases with greater chronological age and the presence of classic risk factors (hypertension, dyslipidemia, cardiovascular disease, obesity, arrhythmias, etc.) and specific risk factors for women (eclampsia, polycystic ovary, microvascular injury pattern, etc.). Diabetes mellitus (DM) is a spreading disease and plays an early role in the pathogenesis of atherogenesis and cardiac structural changes that determine a two and a half times higher prevalence of HF, and an increased signal of early mortality by direct mechanisms. associated with cardiac structural damage (myocardiocyte-interstitium-collagen support) or vascular alterations, multivessel, multistage, multiorgan.

With all this, the per se definition of HF is difficult because it involves clinical (signs and symptoms), imaging (compatible echocardiogram), and enzymatic criteria (natriuretic peptides, ProBNP-BNP) that are not always available in all latitudes. However, the syndrome caused by structural and/or functional cardiac abnormalities that generate a reduction/inefficiency of cardiac output resulting in an inadequate supply of oxygen to the tissues could be taken as a working definition. This definition can encompass the subclassifications of origin: left-right, diastolic-systolic or the current definitions of HF with preserved left ventricular ejection fraction (Ef >50% decreased, Eff <40% or moderately decreased or recovered with the intermediate Fey cutoff values >40<50%).