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Emergency: requires immediate attention
Congestive heart failure
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Emergency: requires immediate attention

Congestive heart failure

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Contributors: Peter Joo, Christine Osborne MD, Ryan Hoefen MD, PhD, Abhijeet Waghray MD
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Synopsis

Congestive heart failure : Fatigue, Cigarette smoking, Mental status alteration, Neck vein distension, Pleural effusion, Peripheral leg edema, Dyspnea, Hypertension, Orthopnea, Rales, Cold lower extremities
Congestive heart failure is a clinical syndrome of fatigue, dyspnea, orthopnea, and fluid retention caused by inability of the cardiac output to meet the body's metabolic demand due to either impaired ventricular filling (diastolic heart failure; heart failure with preserved ejection fraction: normal left ventricular ejection fraction [LVEF]) or reduced ejection of blood (systolic heart failure; heart failure with reduced ejection fraction: LVEF ≤ 40). Diastolic and systolic heart failure are also known as heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). Underlying causes include coronary artery disease, valve dysfunction, hypertension, cigarette smoking, diabetes, infections, medications, and infiltrative disease.

Patients report vague symptoms of fatigue and shortness of breath, especially when lying down, needing to sleep with multiple pillows or on a recliner to breathe properly, and waking up during the night gasping for breath (paroxysmal nocturnal dyspnea).

The incidence increases with age and is higher in men than in women. According to the Framingham Study, the lifetime risk of developing heart failure is approximately 20% for people over the age of 40. The median survival time for men with congestive heart failure is 1.7 years; median survival time for women is 3.2 years. The 5-year survival rate is 25% in men and 38% in women.

Codes

ICD10CM:
I50.9 – Heart failure, unspecified

SNOMEDCT:
42343007 – Congestive Heart Failure

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:02/06/2019
Last Updated:02/06/2019
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Emergency: requires immediate attention
Congestive heart failure
Captions Print   View all Images (5)
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Congestive heart failure : Fatigue, Cigarette smoking, Mental status alteration, Neck vein distension, Pleural effusion, Peripheral leg edema, Dyspnea, Hypertension, Orthopnea, Rales, Cold lower extremities
Imaging Studies image of Congestive heart failure
PA chest xray demonstrating interstitial pulmonary edema with linear opacities throughout both lungs, peribronchial cuffing, and bilateral small pleural effusions, right, (small red arrow), and left, (small yellow arrow). In addition, there is a large hiatal hernia, (long red arrow).

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