Please, previous to this Module, review this video from CHOP

Definition of congestive heart failure (HF) has changed over time with our understanding of the pathophysiology of the failing heart. In the 1950s, HF was described as a clinical syndrome caused by low cardiac output. American College of Cardiology (ACC)/AHA task force on practice guidelines published in 2005 described HF in children as a clinical and pathophysiological syndrome that results from ventricular dysfunction, volume or pressure overload, either alone or in combination … HF is characterized by typical symptoms and signs associated with specific circulatory, neurohormonal, and molecular abnormalities.

Finally, Yancy et al in 2013 described HF as “Complex clinical syndrome that results from any structural o functional impairment of ventricular filling or ejection of blood… cardinal manifestations include dyspnea and fatigue”.

Classification of HF depends on:

• Types of failing ventricle: right failure/ left failure/ biventricular failure, but in congenital heart disease (CHD) in some cases RV is in systemic position, or patient has a single ventricle.
• Systolic or diastolic dysfunction (or HF with preserved systolic function)
• Outcomes: acute HF / chronic HF including the concepts of Compensated / Decompensated HF depending whether end-organ perfusion is maintained or not
• Depending of cardiac output (CO): reduced CO (majority of cases) or increased/ high CO (hypertyroidism crisis or arterio-venous fistula, as examples)

”End-stage HF” is the final common pathway of all forms of heart disease and the only option is a heart transplant.