Heart failure (HF) is defined as the inadequate ability of the heart to pump enough blood to meet the blood flow and metabolic demands of the body.1 High-output HF is characterized by an inordinate increase in the body's metabolic demands, which outpaces an increase in cardiac output (CO) of a generally normally functioning heart.

More commonly, low-output HF is a result of low CO secondary to impaired cardiac function. In this chapter, HF will refer to low-output HF.

HF is a clinical syndrome characterized by a history of specific signs and symptoms related to congestion and hypoperfusion. As HF can occur in the presence or absence of fluid overload, the term HF is preferred over the former term "congestive HF." HF results from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood.1 Many disorders such as those of the pericardium, epicardium, endocardium, or great vessels may lead to HF, but most patients develop symptoms due to impairment in left ventricular (LV) myocardial function.

The phrase "acute heart failure" (AHF) is used to signify either an acute decompensation of a patient with a history of chronic HF or a patient presenting with new-onset HF symptoms. Terms commonly associated with HF, such as cardiomyopathy and LV dysfunction, are not equivalent to HF but describe possible structural or functional reasons for the development of HF.

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