Introduction to Heart Failure
- Heart failure is a chronic condition where the heart muscle is unable to pump blood effectively, leading to inadequate blood supply to meet the body’s needs.
- Symptoms include shortness of breath, fatigue, and swelling in the legs and feet.
- Understanding the different types of heart failure is crucial for pharmacy students, as it influences medication selection and patient counselling.
Types of Heart Failure
Heart failure is classified into two main types based on the functionality of the left ventricle:
1. Systolic Heart Failure (HFrEF)
- Definition: Also known as heart failure with reduced ejection fraction (HFrEF), this type occurs when the left ventricle cannot contract normally.
- Ejection Fraction: Reduced ejection fraction, usually below 40%. Normal ejection fraction ranges between 55-65%.
- Causes:
- Coronary artery disease
- Heart attack
- High blood pressure
- Medications:
- ACE inhibitors or ARBs: Relax blood vessels and reduce the workload on the heart.
- Beta blockers: Slow the heart rate and reduce its workload.
- Aldosterone antagonists: Remove excess fluid and prevent scarring in the heart.
- SGLT2 inhibitors: Originally for diabetes, these help remove excess glucose and fluid, showing significant benefits in heart failure.
- Diuretics: Help the body eliminate excess fluid, alleviating symptoms like shortness of breath and swelling.
2. Diastolic Heart Failure (HFpEF)
- Definition: Known as heart failure with preserved ejection fraction (HFpEF), this type occurs when the left ventricle becomes stiff and cannot relax properly.
- Ejection Fraction: Normal or slightly above normal ejection fraction, as the heart can still contract but cannot fill adequately with blood.
- Causes:
- High blood pressure
- Diabetes
- Obesity
- Medications:
- Treatment focuses on managing underlying conditions and relieving symptoms, as there are fewer effective medications specifically for HFpEF.
- Medications to control blood pressure: Such as ACE inhibitors, ARBs, or beta blockers.
- Diuretics: To manage fluid retention.
Comparing Systolic and Diastolic Heart Failure
| Feature | Systolic Heart Failure (HFrEF) | Diastolic Heart Failure (HFpEF) |
|---|---|---|
| Left ventricle function | Weakened contraction, reduced ability to pump blood | Stiffness, reduced ability to relax and fill with blood |
| Ejection fraction | Reduced (less than 40%) | Preserved (normal or slightly above normal) |
| Symptoms | Similar to HFpEF but often more pronounced | Shortness of breath, fatigue, swelling |
| Treatment | Focuses on improving heart’s pumping ability | More challenging, focuses on managing underlying conditions and relieving symptoms |
Conclusion
Understanding the differences between systolic and diastolic heart failure is crucial for pharmacists to provide optimal care for patients. Recognising the different presentations, causes, and treatment approaches allows pharmacists to play a vital role in improving patient outcomes.
References
- Johns Hopkins Medicine. (n.d.). Heart Failure. Retrieved from Johns Hopkins Medicine.
- Cleveland Clinic. (n.d.). Heart Failure: Understanding Heart Failure. Retrieved from Cleveland Clinic.
- American Heart Association. (n.d.). Classes of Heart Failure. Retrieved from American Heart Association.
- Mayo Clinic. (n.d.). Heart Failure: Symptoms and Causes. Retrieved from Mayo Clinic.
- Heart Failure Matters. (n.d.). What Are the Different Types of Heart Failure?. Retrieved from Heart Failure Matters.
