141. Chapter 5: Heart Failure - Cardiovascular Diseases 5 heart failure. 5.1a. heart failure is characterised by breathlessness, fatigue and fluid retention resulting from pump failure of the heart. http://hebw.uwcm.ac.uk/cardio/chapter5.html

CARDIOVASCULAR DISEASES Team Leader: Dr David Fone Date of completion: 5: Heart failure This bulletin is a supplement to, not a substitute for, professional skills and experience. Users are advised to consult the supporting evidence for a consideration of all the implications of a recommendation. The Statements The Evidence 5.1 Clinical guidelines Heart failure is characterised by breathlessness, fatigue and fluid retention resulting from pump failure of the heart. It is a major public health problem, affecting around 1% of the general population and 10% of the elderly; 50% of patients die within a five year period i Evidence-based guidelines are available for the evaluation and management of heart failure i-iv (Health gain notation - 1 "beneficial ") i. Konstam M, Dracup K, Baker D, et al. Heart Failure: Evaluation and Care of Patients With Left-Ventricular Systolic dysfunction Clinical Practice Guideline Number 11 AHCPR. Rockville, MD: Agency for Health Care Policy and Research and the National Heart, Lung and Blood Institute, Public Health Service, U.S. Department of Health and Human Services, 1994 http://www.ahcpr.gov/clinic/

142. Heart Failure heart failure. Medical Illustration of heart failure. Roll your mouse pointer over the image to view heart failure. Legend. http://www.ahaf.org/hrtstrok/about/HeartFailure2.htm

HEART FAILURE Roll your mouse pointer over the image to view heart failure Legend The red arrow indicates the flow of oxygenated blood coming from the lungs and pumped out to the body by the left ventricle. Heart failure (roll mouse pointer over image) can diminish the ability of the left ventricle to pump blood, indicated by the thinner red arrow. The blue arrow indicates the flow of blood low in oxygen coming from the body and pumped out to the lungs by the right ventricle. Heart failure (roll mouse pointer over image) can diminish the ability of the right ventricle to pump blood, indicated by the thinner blue arrow. The muscle tissue enlarges and increases in thickness (roll mouse pointer over image) to make up for the decreasing capacity of the heart to pump blood. Eventually, this compensatory mechanism fails. The term congestive heart failure is often used to describe all patients with heart failure. Actually, congestion (the build-up of fluid in the lungs or lower limbs) is just one feature of the condition and does not occur in everyone. Heart failure is a chronic condition characterized by the heart's diminished ability to pump blood effectively. Factors such as smoking, coronary artery disease, hypertension, high cholesterol levels, diabetes, heart valve abnormalities, and obesity can increase the risk of developing heart failure. For example, coronary artery disease may cause the development of small areas of damage over the years, heart attacks cause muscle tissue to be replaced by scar tissue and high blood pressure may result in the left pumping chamber of the heart (left ventricle) to overwork and weaken. The heart tries to compensate for the failure in two ways:

143. Cardiology Online - International Academy Of Cardiology Cardiology Online is a cardiology guide and directory for congresses, meetings and publications on heart disease and heart failure of the International Academy http://www.cardiologyonline.com/

Last updated 05/22/2004 14:07 C lick here to download brochure (Call for Abstracts) C ... lick here to download Preliminary List of Scientific Presentations The International Academy of Cardiology is dedicated to the advancement of global research in cardiovascular medicine through the support of scientific meetings and publications. FUTURE MEETINGS C ARDIOLOGY ONLINE NEWS WORLD CONGRESS ON HEART DISEASE - NEW TRENDS IN RESEARCH, DIAGNOSIS AND TREATMENT ... Studies Suggest Rate Control Equal to Rhythm Control in Some AF Patients MEETINGS UNDER THE AUSPICES OF THE INTERNATIONAL ACADEMY OF CARDIOLOGY 53rd INTERNATIONAL CONGRESS OF THE EUROPEAN SOCIETY FOR CARDIOVASCULAR SURGERY June 2-5, 2004 Ljubljana, Slovenia October 9-13, 2004 ... Beijing, China PREVIOUS CONGRESSES INTERNATIONAL ACADEMY OF CARDIOLOGY 3rd WORLD CONGRESS ON HEART DISEASE - NEW TRENDS IN RESEARCH, DIAGNOSIS AND TREATMENT

144. Congestive Heart Failure Canadian site looking at prevention and treatment as well as evaluation of this disease. http://www.santepub-mtl.qc.ca/mdprevention/fiches/coeur/heart.html

Congestive heart failure The most frequent causes of relapse are improper observance of treatment, poorly controlled hypertension, other heart problems, and infections. How can we talk about prevention? Simply by examining the causes, i.e. ischaemic heart disease, high blood pressure, cardiomyopathies, diabetes, and valvulopathies. Since the first two conditions are the most frequently associated, we believe that there is a link between strategies for preventing ischaemic heart disease and the prevention of heart failure. Heart Failure Continuum of Heart Failure Prevention Evaluation of Heart Failure Treatment of heart failure according to the type of ventricular dysfunction Resources No resources for patient Comments and suggestions: Dr Jean Cloutier Collaboration Association des Médecins Omnipraticiens de Montréal Information is updated regularly Update : July 7, 1999 Haut

145. Heart Failure: Lifeclinic.com heart failure occurs when the heart can t pump enough blood to meet the needs of the body. Lifeclinic.com from Spacelabs Medical, heart failure. http://www.lifeclinic.com/focus/heartfailure/default.asp

document.write(''); Key Word Search Basic Facts How to Lower It Monitoring Your BP Visiting Your Doctor ... For Physicians Resources Medications Find a Doctor Cookbook Hypertension Dictionary ... Health Station Demo Heart Failure About Heart Failure Incidence Types Causes ... News

146. Congestive Heart Failure Congestive heart failure. What is congestive heart failure? What can I do to help prevent recurrence of congestive heart failure? http://www.beryl.net/HTL/Heart/22203.htm

Congestive Heart Failure What is congestive heart failure? Congestive heart failure means your heart is not pumping effectively. While it is not the same as cardiac arrest (when the heart stops beating) or a heart attack (when the heart muscle is suddenly damaged by an inadequate blood supply), it does require regular medical attention. How does it occur? Congestive heart failure may be the result of one or more of the following: What are the symptoms? The major symptoms of congestive heart failure are: How is it diagnosed? Your doctor may order several tests, including: If you are hospitalized as a result of your symptoms, your doctor may have a pulmonary artery catheter inserted in a vein to measure how well your heart is working and to help determine why your heart is not pumping effectively. How is it treated? There are three goals in managing congestive heart failure: The following factors can worsen or trigger congestive heart failure in people with weakened hearts. Your doctor will want to control these factors: Your doctor may prescribe ACE inhibitor drugs (converting enzyme inhibitor) to treat congestive heart failure. These drugs are known as vasodilators because they dilate the arteries. Dilating the arteries reduces the work the heart has to do, which allows it to pump blood more effectively.

147. Heart Failure of heart failure, its causes, diagnosis, treatment and when to call a physician. Information from the AAFP....... http://familydoctor.org/119.xml

Advanced Search familydoctor.org Home Conditions A to Z Heart Failure What is heart failure? What causes heart failure? What are the symptoms of heart failure? What tests will I need? ... When should I call my doctor? Heart Failure Printer-friendly version Email this article What is heart failure? Despite the way it sounds, the term "heart failure" simply means that your heart isn't pumping blood as well as it should. Heart failure doesn't mean your heart has stopped working or that you are having a heart attack. Heart failure is also called congestive heart failure, or CHF. "Congestive" means fluid is building up in the body because the heart isn't pumping properly. Return to top What causes heart failure? Heart failure has many different causes. Sometimes the exact cause can't be found. The most common causes of heart failure are listed below: Coronary artery disease (narrowing of the blood vessels to the heart)often people with heart failure have had a heart attack in the past Problems with the heart muscle itself (known as cardiomyopathy) High blood pressure (also known as hypertension) Problems with any of the heart valves Abnormal heart rhythms (also called arrythmias) Toxic substances (such as alcohol abuse) Congenital heart disease (a heart problem you were born with) Return to top What are the symptoms of heart failure?

148. Diastolic Heart Failure MEDSTUDENTS-CARDIOLOGY of current knowledge about incidence, pathophysiology, clinical expression, diagnosis, laboratory evaluation and management of diastolic heart failure and its http://www.medstudents.com.br/cardio/cardio5.htm

Cardiology Eduardo Benchimol Saad, MD Medstudents' Homepage Diastolic Heart Failure Congestive heart failure ( HF ) may be considered a condition in which cardiac output is not adequate to meet the metabolic needs of the body, either at rest or with exercise, usually accompanied by an increase in cardiac filling pressure and / or volume. Implicit in that physiological definition is that HF can be caused by an abnormality in systolic function leading to a defect in expulsion of the blood ( systolic HF ), or by an abnormality in diastolic function leading to a defect in ventricular filling ( diastolic HF ). The former is the more familiar, classic HF in which an impaired inotropic state is responsible. Less familiar, but perhaps just as important, is diastolic HF, in which the ability of the ventricle (s) to accept blood is impaired. This problem is not rare, accounting in some series for as many as one third of patients presenting with HF. This article, the last from a total of four reviewing current aspects of Heart Failure , aims at discussing pathophysiological, clinical, diagnostic and therapeutic aspects of this form of HF.

149. Temple University: Heart Failure & Transplant Program Information about comprehensive care for heart failure and heart transplant patients as well as the facilities. Delaware. http://www.temple.edu/heartfailure

To reach staff, make an appointment, get a referral. Latest information about the program and relevant updates Clinical trials and studies currently underway. Our resources will direct you to related sites. The Delaware Valley’s Premier Heart Program The Temple Cardiomyopathy and Cardiac Transplant Center stands at the forefront of comprehensive care for patients with end-stage cardiomyopathy. Temple has performed over 800 heart transplants and is one of the busiest adult heart transplant centers in the United States. Search Feedback

150. Heart Failure Treatment Program: UI Heart Care: UI Health Care The heart failure Treatment Program at University of Iowa Hospitals and Clinics. UI Heart Care Home heart failure Treatment Program. Programs and Services http://www.uihealthcare.com/depts/uiheartcare/services/heartfailureprogram/

UI Heart Care Home Appointments Pediatric Cardiology CHAMPS (Cardiovascular Rehabilitation) ... Research - UI Health Care's digital library Read this month's health-e-newsletter Send comments and questions to staff@uihealthcare.com University of Iowa UI Heart Care Heart Failure Treatment Program Programs and Services: Heart Failure Service Cardiac Transplant Service Ventricular Assist Device Program Pulmonary Hypertension Program ... Clinical Trials News Feature Stories: When Hearts Fail UI Hospitals and Clinics's Team of Cardiac Specialists Provides Broad Spectrum of Care Pacemaker, Vol. 21, No. 9, September 1994 Electric VAD Provides Bridge to Heart Transplant Pacemaker, Vol. 24, No. 1, January 1997 Heart Failure Patient Education Links to Heart Care Sites Contact Us With Questions: Physician-related Nurse-related General questions Doctors and nurses are available 24 hours a day to assist patients and referring doctors. For more information on the Heart Failure Treatment Program with UI Heart Care, call 319-356-1028. UI Health Care Home About Us Appointments Contact Us ... Search Information for: Patients/Visitors Health Care Professionals Residents/Fellows Students ... We Welcome Your Comments and Questions Last modification date: Wed Mar 10 15:06:36 2004 URL: http://www.uihealthcare.com/depts/uiheartcare/services/heartfailureprogram/index.html

151. SETON.net HEALTH. CARE. MADE SIMPLER. A look at the facilities and the heart failure team as well as information about this disorder. http://www.goodhealth.com/livewell/heartcenter/cr/one/

Jobs Doctors Services Locations ... Classes (Choose Below) SETON.net Jobs Doctors Services Locations Classes Good Health Mag Recipes Seton Health Plan The SETON Healthcare Network is the leading provider of healthcare services in Central Texas. SETON is a not-for-profit organization. Our Facilities Phone Directory Come celebrate the new Children's Medical Center of Central Texas Patient and Family Information to help make the healthcare experience easier for you. Find a doctor, explore our facilities and learn about patient care services and programs. Illnesses and Conditions Take charge of your health. Review our library of articles, web resources and classes on heart disease, cancer, diabetes, and stroke. Wellness Interested in managing stress? Want to increase your activity level? Whatever your needs, here is advice to help you achieve a healthier lifestyle. Health Insurance Get the information you need about the SETON Health Plan. Our plans cover health care needs from preventive care to serious illness and injury. About SETON SETON is the region's largest public service organization. Find out how to help us in providing care to all who need it without regard to ability to pay.

152. Chronic Heart Failure: Management Of Chronic Heart Failure In Adults In Primary Print, Up. Down. Chronic heart failure Management of chronic heart failure in adults in primary and secondary care. NICE has issued http://www.nice.org.uk/cat.asp?c=79725

153. Cardiology Associates Of West Reading Details about the practice and services which include cardiac stress testing, EKGs, cardiac consultations, treatment of congestive heart failure. Lists locations in Pennsylvania and contact details. http://www.cawr.net/

Heart Attack Warning Signs Some heart attacks are sudden and intense the "movie heart attack," where no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening: Chest discomfort . Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain. Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach. Shortness of breath.

154. Congestive Heart Failure (CHF) - Lucile Packard Children's Hospital Cardiovascular Diseases. Congestive heart failure (CHF) What is congestive heart failure (CHF)? What causes congestive heart failure? http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/cardiac/chf.html

Arrhythmia Service/Electrocardiography (ECG) Laboratory Cardiac Catheterization / Angiography Cardiology Cardiothoracic Surgery ... Packard Heart Surgeon Performs Operation on Smallest Infant Cardiovascular Diseases Congestive Heart Failure (CHF) What is congestive heart failure (CHF)? Congestive heart failure (CHF) is a condition in which the heart cannot pump enough oxygenated blood to meet the needs of the body's other organs. The heart keeps pumping, but not as efficiently as a healthy heart. Usually, the loss in the heart's pumping action is a symptom of an underlying heart problem. What causes congestive heart failure? Congestive heart failure often occurs in children with congenital (present at birth) heart defects. Other medical problems that can cause CHF include, but are not limited to, the following: heart valve disease caused by past rheumatic fever or other infections infections of the heart valves and/or heart muscle (i.e., endocarditis) cardiac arrhythmias (irregular heartbeats) cardiomyopathy, or another primary disease of the heart muscle

155. Congestive Heart Failure Congestive heart failure by Hiba Tamim, MD. Patients with sickle syndromes most commonly develop heart failure from high output secondary to anemia. http://www.scinfo.org/chf.htm

Sickle Cell Information Center Guidelines Edited by James Eckman, M.D. and Allan Platt, PA-C Congestive Heart Failure by Hiba Tamim, MD Patients with sickle syndromes most commonly develop heart failure from high output secondary to anemia. Symptoms of dyspnea on exertion, palpitations, and weakness and physical findings of murmurs, third heart sounds, and enlarged heart, which occur because of the anemia, may be mistaken for intrinsic cardiac disease. Older patients and those who receive frequent transfusion may develop cardiac disease which may lead to heart failure. Clinical Findings Subjective Data Present Illness . Note onset of symptoms, presence of edema, dyspnea on exertion, PND, orthopnea, chest pain, cough, fever, or palpitations. Past Medical History . Document history of murmur, rheumatic fever, hypertension, myocardial infarction, cardiac evaluation, and transfusion history including the total number of units transfused. Review of Symptoms . Determine present medications, allergies and do a general ROS. Objective Data Physical Examination General. Pallor, degree of distress.

156. Passive Smoking And The Risk Of Coronary Heart Disease A metaanalysis of epidemiologic Studies published in the New England Journal of Medicine indicates secondhand smoke causes heart attack, atherosclerosis or hardening of the arteries, congestive heart failure and other cardiovascular problems. http://216.185.112.5/presenter.jhtml?identifier=3172

157. Congestive Heart Failure Congestive heart failure. Large Market Growing Market Congestive heart failure (CHF) afflicts over 15 million patients worldwide. http://www.bioscorpio.com/congestive_heart_failure.htm

Congestive Heart Failure Large Market Growing Market Congestive heart failure (CHF) afflicts over 15 million patients world-wide. According to the American Heart Association (AHA) (U. S.), an estimated 4.7 million patients were diagnosed with congestive heart failure in the U. S. in 2001. Approximately 1.5 million of these patients have moderate-to-severe form, or New York Health Assessment (NYHA) class III-IV of CHF An estimated 1 million hospitalizations each year in the U. S. are attributed to a primary diagnosis of congestive heart failure. Particularly, for people over the age of sixty-five, CHF is the leading cause of hospitalization. Currently, only about 50 percent of patients with congestive heart failure are expected to survive for more than five years from the time of diagnosis. Approximately 250,000 deaths annually are due to CHF. An estimated 100,000 patients with end-stage CHF are candidates for ventricular assist devices (VADs) in the U. S. Diastolic form of heart failure is estimated to account for 30-50% of all heart failure cases Pipeline Adentri™ (A1 Adenosine Receptor Antagonist, BG9719, CVT-124)

158. Congestive Heart Failure Precise diagnosis and therapy restore function and extend life for patients with congestive heart failure. Jesse Green, PhD; Senior Director, Clinical Evaluation and Outcomes Research. http://mcrcr4.med.nyu.edu/hcsolutions/hcs01_05/01_05.htm

Health Care Solutions; Volume 1, Issue 5; Oct 97 Revitalizing a Failing Heart: Precise diagnosis and therapy restore function and extend life for patients with congestive heart failure. Jesse Green, PhD; Senior Director, Clinical Evaluation and Outcomes Research Inside This Issue: Days Away from a Massive Heart Attack Life-Saving Diagnostics Echocardiography's Role in CHF Seeing is Believing ... Further Information Days Away from a Massive Heart Attack "I didn't know it at the time, but I was days away from a massive heart attack," said 58-year-old Wim van Akelijen. "I would be walking in the street and have to stop at every corner to get my breath back. It was impossible to walk up stairs - and simple things like combing my hair and brushing my teeth took a tremendous effort. "For a long time I thought I had the flu, but it wouldn't go away. When I went to my own doctor he told me I had congestive heart failure, but he felt that a diet was the solution. So I was eating rice and beans for weeks. But soon it became clear that I wasn't getting any better. I told him he had to get me to a cardiologist. In 1994, he referred me to NYU Medical Center." Quick Action Almost immediately, van Akelijen underwent a battery of tests. An echocardiogram revealed that his heart had an ejection fraction of only 20 percent and an angiogram revealed that he had severe coronary artery disease - the leading cause of congestive heart failure - which can cause myocardial infarction.

159. Welcome To Jon's Place Jon s place heart failure support, plain English information, answers and honesty. How to cope heart failure Forum. Everyone who has http://www.jonsplace.org/CHFjonsplace.htm

Updated February 28, 2004 Welcome to Jon's Place! I'm a stubborn, opinionated ex-smoker , ex-drinker, ex-cabinetmaker, and I am completely hooked on Jesus . Oh yeah, a little condition called cardiomyopathy almost sent me to my grave and it gave me another delightful little condition called heart failure! My pages will give you some of the best information about heart failure you'll find anywhere, hands down. This advice is given by patients, from a patient's viewpoint. Who can tell you better about the day to day problems of living with this disease, than people who have it? Please read this whole page to get a running start on coping with your heart failure. Then read The Manual . The Manual contains the most helpful and practical information all on one page - in plain English - instead of you having to collect it a piece at a time from doctors, nurses, magazines, TV, and people who claim to be experts but never are. With The Manual under your belt, you will be ready to start asking questions at The Beat Goes On , our message boards for talking to each other about just about everything heart-related. You can add yourselves to the heart information

160. MeritCare Bemidji Family practice, emergency care, and surgery. Has a congestive heart failure clinic. Staff, specialties, contact information. http://www.meritcare.com/guidebook/directories/locationinfo.asp?id=26

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