Author Description

Heart failure is a complex clinical syndrome that can arise from any structural or functional disorder that impairs the heart's ability to properly fill or eject blood. The major manifestations of heart failure are breathlessness and fatigue, which may limit exercise tolerance, and fluid retention, which may lead to pulmonary congestion and peripheral edema. The presence of heart failure adversely affects one's quality of life and shortens survival. Eighty percent of men and 70% of women under the age of 65 who have heart failure will die within 8 years. Heart failure is a major public health issue in the United States. Nearly 5 million patients in the United States have heart failure and 500,000 patients are diagnosed with heart failure for the first time each year. The disorder is the underlying reason for 3.4 million office visits and was the principal diagnosis for 1.1 million hospital discharges in 2005. The management of patients with heart failure has evolved dramatically over the past two decades. In the past, heart failure was viewed as simply a problem of a weakened heart unable to pump a sufficient supply of blood to the body. Heart failure is now best explained by a biomechanical model that emphasizes the intertwining processes of progressive cardiac structural remodeling and ongoing neurohormonal activation that together produce the adverse symptoms of heart failure. Knowledge of this model has led to novel therapies, including beta-blockers (which were once believed to be contraindicated for heart failure), biventricular pacemakers and innovative surgical techniques. The number of specialized heart failure centers with multidisciplinary teams has increased, but primary care providers continue to care for the majority of heart failure patients. Oxford American Cardiology Library: Heart Failure: The Essential Clinician's Guide provides these primary care physicians with concise, easily accessible guidance on the prevention, diagnosis, and