Heart Failure (aka Congestive Heart Failure) - Imaging
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Heart Failure
Classically, a syndrome of poor heart squeeze that results in volume overload (peripheral edema, pulmonary edema, dyspnea on exertion); however, the American Heart Association defines Heart Failure prefers a less obvious restricted definition of: a complex clinical syndrome that results from structural or functional impairment of ventricular filling/ejection, which leads to dyspnea and fatigue: because many patients will not present with volume overload.
This is why the term "congestive heart failure" is no longer used, it presumes that all patients with heart failure develop volume overload (but they do not).
Key Etiologies
Poor Ejection Fraction (< 40%)
Coronary artery disease
- Myocardial infarction/ischemia
- Secondary to chronic hypertension, diabetes mellitus, hyperlipidemia, TOB abuse
- Chronic pressure overload
- Hypertension
- Obstructive valvular disease (eg, aortic stenosis).
- Chronic lung disease
- Pulmonary hypertension leads to right heart failure (cor pulmonale)
- Infectious Causes
- Viral Myocarditis
- Chaga's disease due to parasitic Trypanosoma cruzi infection
- Toxic/Drug-Induced
- Cocaine, Methamphetamine
- Chemotherapies (Anthracyclines, HER-2 antagonists)
- Primary hypertrophic cardiomyopathy
- Fibrosis
- Storage disorder (eg, hemochromatosis) or infiltrative disorder (amyloidosis, sarcoidosis)
- Metabolic Disorders
- Thyrotoxicosis
- Thiamine deficiency
Special thanks to mushin111 for source images of normal heart MRI