Thread by @sanujthomas

#HeartFailure (HF) is classified on the basis of ejection fraction (EF) and then into classes and stages. Let's have a look at what each of these mean to a physician in a clinical setting . A 🧵 (1/13)

#MedTwitter #MedEd #medicine
#CardioTwitter #Cardiology

#Heartfailure 💔 is a clinical syndrome that results from a structural or functional impairment of one or both ventricles. Ventricular filling and ejection are thus, hampered.
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On the basis of EF, HF is classified into
1️⃣Heart failure with reduced ejection fraction(HFrEF)
2️⃣Heart failure with improved ejection fraction(HFimpEF)
3️⃣Heart failure with mildly reduced ejection fraction(HFmrEF)
4️⃣Heart failure with preserved ejection fraction(HFpEF)
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✴️Heart failure with reduced ejection fraction (HFrEF):
Previous LVEF ≤40% and remains the same at follow up
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✴️ Heart failure with improved ejection fraction (HFimpEF):
Previous LVEF ≤40% and a follow-up measurement of LVEF >40%
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✴️Heart failure with mildly reduced (formerly mid range) ejection fraction (HFmrEF): Here LVEF is between 41%–49% with
evidence of spontaneous or provoked increase in LV filling pressures (eg, elevated natriuretic peptide, noninvasive and invasive hemodynamic measurement).
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✴️Heart failure with preserved ejection fraction (HFpEF): LVEF ≥50% with evidence of spontaneous or provoked increase in LV filling pressures
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#Heartfailure evolves over several stages. They are;
✴️Stage A: At risk for HF
✴️Stage B: Pre HF
✴️Stage C: Symptomatic HF
✴️Stage D: Advanced/Refractory HF
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🔵 Patients who present with HF symptoms and signs to the hospital are at least stage C or above.
🔵 Even when heart failure features have resolved, these patients will still be categorised as stage C.
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Interpretation of each heart failure stage👇:

Source: ahajournals.org/doi/10.1161/CI…
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The degree of functional limitation in heart failure is assessed using the New York Heart Association (NYHA) classification👇:
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*Angina is also included in the symptoms

If we were to compare the stages of heart failure with functional limitations, this is how it would look:
#medicine #CardioTwitter
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For further reading on heart failure 👇
ahajournals.org/doi/10.1161/CI…
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