Clinical features of Heart Failure

Symptoms and signs of Heart Failure

1. Heart failure with reduced Ejection Fraction (HFrEF)

2. Heart failure with preserved Ejection Fraction (HFpEF)

3. High output state Heart Failure

4. Cor Pulmonale
NYHA CLASSIFICATION
Heart Failure with reduced Ejection Fraction

HFrEF

Acute Coronary Valvular Heart

Syndromes Conditions
 Heart Failure with preserved Ejection Fraction
(HFpEF)
Symptoms

● Breathlessness- exertional followed by at rest

● Fatigue
● Orthopnoea and PND
● Pedal edema
● Exercise intolerance
● Anorexia, nausea, abdominal pain and fullness
● Confusion, disorientation
● Sleep and mood disturbances
● Nocturia
 HFpEF- Signs
● Cool peripheral extremities
● Increased BMI
● Bilateral pitting pedal edema
● Elevated JVP
● Bilateral pulmonary crackles
● Apex beat is shifted downward and outward if cardiomegaly is present
● Palpable and audible S3 gallop at the apex
● Hepatomegaly
● Ascites and jaundice in later stages
 High Output states
Etiology

● Metabolic disorders
● Thyrotoxicosis
● Nutritional deficiency- Beri Beri
● Chronic anaemia
● Systemic arteriovenous shunting
 High Output states
Symptoms Signs

● Shortness of breath ● Pallor

● Fatigue ● Pedal edema
● Palpitations ● Tachycardia and Tachypnoea
● Restlessness and ● Hypotension
irritability ● Hemic murmur in case of chronic severe
● Lightheadedness anaemia
● Signs of Grave’s disease
● Swelling of legs
● Signs of Vitamin B1 deficiency- tingling
sensation, rashes, dyspnoea,pedal edema
 Cor Pulmonale
Symptoms
● Dyspnoea at rest
● Pedal edema
● Abdominal distension
● Fatigue
● Orthopnoea
Signs
● Swollen face
● Central cyanosis, bilateral pitting pedal edema