Overview
HFrEF is a heart failure phenotype characterized by reduced left ventricular systolic function.
Ischemic heart disease, cardiomyopathy, hypertension, and valvular disease are among important underlying causes.
Clinical Features
Symptoms include dyspnea, fatigue, reduced exercise tolerance, orthopnea, and edema.
Examination may reveal raised JVP, crackles, displaced apex, or peripheral edema.
Investigation
Echocardiography establishes ventricular function and identifies structural disease. ECG, blood testing, and assessment for ischemia or valvular disease help identify the cause.
Management
Evidence-based management includes disease-modifying pharmacological therapy, treatment of congestion, management of comorbidities, and device therapy in selected patients.
HFrEF management targets both symptoms and long-term remodeling and cardiovascular outcomes.
Clinical Pearls
HFrEF is fundamentally a problem of impaired systolic function, but treatment must still address congestion and the underlying cause.
END OF REVIEW
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