1. HTN
2. MI or Ischemia
3. Drug induced
4. Volume overload
5. Pressure overload
6. Dilated cardiomyopathies

1. HTN
2. Ventricular hypertrophy (pressure overload)
3. MI or Ischemia
4. Valve stenosis
5. Pericardial disease

1. Lack of compliance
2. Arrhythmias
3. Pulmonary Infection
4. MI/CAD/Valvular Disease/Dilated Cardiomyopathy
5. Uncontrolled HTN
6. Environmental
7. Emotional Stress
8. Thyrotoxicosis

1. Androgens, Estrogens, Licorice, NSAIDs, Salicilates, Corticosteroids: increase Na/H2O retention
2. TCA, Antiarrhythmics, BB: decreased contractility

Symptoms:

1. Abdominal pain
2. Nausea
3. Constipation
4. Anorexia
5. Bloating
6. Ascites

Signs:

1. Peripheral edema
2. Hepatomegaly
3. Jugular Venous Distention (JVD) or Jugular Venous Pressure (JVP)
4. Hepatojugular Reflex (HJR)

Symptoms:

1. Dyspnea on Exertion
2. Paroxysmal Nocturnal Dyspnea (PND)
3. Orthopnea
4. Tachypnea
5. Cough
6. Hemoptysis

Signs:

1. Bibasilar rales
2. Pulmonary edema
3. S3 gallop
4. Pleural effusion
5. Cheyne-Stokes Respiration

Symptoms:

1. Exercise intolerance
2. Fatigue
3. Weakness
4. Nocturia
5. CNS Symptoms

Signs:

1. Tachycardia
2. Pallor
3. Cyanosis of digits
4. Cardiomegaly

1. Exercise
2. Na Restriction
3. Fluid avoidance
4. Support groups
5. Placement of Implantable Cardioverter-Defibrillator (ICD) --> consider this option over antiarrhythmic agents if EF <30% 
6. Cardiac resynchronization therapy: biventricular pacemaker --> indicated for Class III-IV NYHA receiving optimal therapy

1. Diuretics
2. ACEI or ARBs
3. Beta Blockers
4. Digoxin
5. Spironolactone/Eplerenone
6. Warfarin/Antiplatelet

• High risk patient that does not yet have HF
• No identified structural/functional abnormalities
• No signs/symptoms of HF

Examples:

1. HTN
2. CAD
3. DM
4. cardiotoxic drug therapy
5. alcohol abuse
6. h/o rheumatic fever
7. FHx of cardiomyopathy

Treat current disease states and have them controlled

Developed structural heart disease associated with HF, but never had signs or symptoms of HF

Examples:

1. LVH or fibrosis
2. LV dilation or hypocontractility
3. Asymptomatic valvular heart disease
4. Previous MI

Current or prior symptoms of HF and underlying structural heart disease

Examples:

1. Dyspnea or fatigue due to LV systolic dysfunction
2. Asymptomatic patients who are undergoing treatment for prior symptoms of HF

Advanced structural heart disease and marked symptoms of HF at rest despite treatments and require interventions

Examples:

1. Frequently hospitalized for HF; cannot be safely discharged from the hospital
2. In hospital awaiting heart transplantation
3. At home receiving IV support for symptomatic relief
4. Mechanical ventilation
5. Hospice setting