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ბოლო მიმოხილვა: 2 Oct 2025
ბოლო განახლება: 29 Jul 2025

შეჯამება

განსაზღვრება

ანამნეზი და გასინჯვა

ძირითადი დიაგნოსტიკური ფაქტორები

  • breathlessness
  • peripheral oedema
  • reduced exercise tolerance
  • fatigue
  • cold extremities
  • elevated jugular venous pressure
  • risk factors
  • displaced apex beat
  • gallop rhythm (third heart sound)

სხვა დიაგნოსტიკური ფაქტორები

  • nocturnal cough
  • wheezing
  • dizziness
  • confusion
  • loss of appetite
  • nocturnal ischaemic pain
  • ascites
  • central cyanosis
  • narrow pulse pressure
  • altered mental status
  • oliguria
  • delayed capillary refill time
  • pulmonary crepitations
  • dullness to percussion/decreased air entry in lung bases

რისკფაქტორები

  • previous cardiovascular disease
  • older age
  • prior episode of heart failure
  • diabetes mellitus
  • family history of ischaemic heart disease or cardiomyopathy
  • excessive alcohol intake
  • smoking
  • cardiac arrhythmias
  • history of systemic conditions associated with heart failure
  • previous chemotherapy
  • medication
  • hypertension
  • valvular heart disease
  • pericardial disease
  • myocarditis
  • excessive salt intake
  • excessive catecholamine stimulation
  • abnormal thyroid function
  • obesity

დიაგნოსტიკური კვლევები

1-ად შესაკვეთი გამოკვლევები

  • ECG
  • chest x-ray
  • natriuretic peptides
  • troponin
  • full blood count
  • urea, electrolytes, and creatinine
  • glucose and HbA1c
  • liver function tests
  • thyroid function tests
  • C-reactive protein
  • D-dimer
  • echocardiography

გასათვალისწინებელი კვლევები

  • venous or arterial blood gas
  • blood tests screening for myocarditis
  • bedside thoracic ultrasound
  • Cardiac magnetic resonance (CMR)
  • Nuclear medicine imaging

მკურნალობის ალგორითმი

კონტრიბუტორები

ექსპერტი მრჩევლები

Shrilla Banerjee, MD, FRCP, FESC

Consultant Interventional Cardiologist

East Surrey Hospital

Surrey and Sussex Healthcare NHS Trust

UK

გაფრთხილება:

SB has received speaker fees for educational lectures (presentation content was her own) and meeting participation from Menarini, Edwards Lifesciences, Abbott Vascular, and Shockwave IVL. She has also participated in an Advisory Board for Sahajanand Medical Technologies Limited. SB has received travel sponsorship from Biosensors International to attend the PCR meeting in Paris in 2022. She has prepared a manuscript on coronary microvascular dysfunction for Abbott for Cardiovascular News (no royalties).

F. Aaysha Cader, MD, MSC (Oxon), MRCP

Cardiology Registrar

Kettering General Hospital NHS Foundation Trust

Kettering

UK

გაფრთხილება:

FAC is co-course director of the APSC-EECC Core cardiology review series. FAC is co-author on several papers with SB.

მადლიერება

Best Practice would like to gratefully acknowledge previous expert contributors, whose work is retained in parts of the content:

Syed Wamique Yusuf, MBBS, FACC, FRCPI

Professor of Medicine

Department of Cardiology

University of Texas

MD Anderson Cancer Center

Houston

TX

Resham Baruah MBBS, BSc, FRCP, MSc, PhD

Consultant Cardiologist

Heart Failure Lead

Chelsea and Westminster Hospital and the Royal Brompton and Harefield NHS Trust

London

UK

Adam D. Hartley MBBS, BSc, MRCP

Wellcome Trust Clinical Research Fellow

Imperial College London

Specialist Registrar in Cardiology

Imperial College Healthcare NHS Trust

London

UK

გაფრთხილება:

SWY is a co-director of the American College of Cardiology (ACC) Cardiovascular Board Review Course, during which he also delivers lectures. RB has received honorarium/speaker fees from Novartis and Boehringer Ingleheim. ADH declares that he has no competing interests.

რეცენზენტები

Lisa Anderson, BSc, MB, ChB, MD

Consultant Cardiologist

Cardiovascular Clinical Academic Group

Molecular and Clinical Sciences Research Institute

St George's, University of London

St George's University Hospitals NHS Foundation Trust

London

UK

გაფრთხილება:

LA was deputy chair for the British Society of Heart Failure clinical advisory board for tafamidis, undertook consultancy services for tafamidis (Pfizer), received a research grant from Pfizer, was on the clinical advisory board for dapagliflozin (AstraZeneca), and received lecture fees from the British Society of Cardiology/AstraZeneca and Pfizer.

James Gamble, BM, BCh, DM, FRCP

Consultant Cardiologist

Oxford Heart Centre

John Radcliffe Hospital

Oxford

UK

გაფრთხილება:

JG has been reimbursed for delivering educational meetings by: Novartis, the manufacturer of sacubitril/valsartan; Boerhinger Ingelhiem, the manufacturer of empagliflocin; AstraZeneca, the manufacturer of dapagliflozin; and Medtronic, the manufacturer of implantable cardioverter defibrillator (ICD) and cardiac resynchronisation therapy (CRT) devices. He has been supported to attend educational meetings by Abbott, Medtronic, and Boston Scientific, who all manufacture ICD and CRT devices. All of these companies produce drugs or devices related to the treatment of heart failure.

რეცენზენტების განცხადებები

BMJ Best Practice-ის თემების განახლება სხვადასხვა პერიოდულობით ხდება მტკიცებულებებისა და რეკომენდაციების განვითარების შესაბამისად. ქვემოთ ჩამოთვლილმა რეცენზენტებმა თემის არსებობის მანძილზე კონტენტს ერთხელ მაინც გადახედეს.

გაფრთხილება

რეცენზენტების აფილიაციები და გაფრთხილებები მოცემულია გადახედვის მომენტისთვის.

ექსპერტი მრჩევლები: თანმხლები დაავადებები

Martyn Patel, BMBcH, FRCP, MA

Consultant, Older People's Medicine

Norfolk and Norwich University Hospitals

NHS Foundation Trust

Norwich

UK

გაფრთხილება:

MP is the NHS representative on the board for Norwich Institute for Healthy Ageing (unpaid role). MP participated in a podcast on the evolving nature and importance of comorbidities for BMJ Best Practice in October 2024. MP is submitting an application to the NIHR Research for Patient Benefit (RfPB) Grant Call on physical frailty, an Integrated Care Board (ICB) priority.

Paul Cockwell, PhD, FRCP

Consultant Nephrologist

Queen Elizabeth Hospital Birmingham

Professor of Nephrology (honorary)

University of Birmingham

Birmingham

UK

გაფრთხილება:

PC is immediate past-president and a trustee of UK Kidney Association (UKKA), which is the UK professional organisation that supports healthcare professionals involved in care for, and research, innovation and education in, kidney disease. UKKA has a broad remit with relationships with multiple partners and includes responsibility for UK Kidney Week, the major educational meeting for UK kidney professionals. PC is medical director for long-term conditions and prevention for NHS Birmingham and Solihull, with responsibilities that include commissioning and transformation of clinical care including areas relevant to the information on chronic kidney disease in the BMJ Best Practice Comorbidity Manager. PC has a non-remunerated research partnership with Boehringer Ingelheim into the epidemiology of chronic kidney disease. PC has received honoraria from Astra Zeneca for leading educational meetings for chronic kidney disease and long-term conditions. PC is author of the BMJ Learning module on chronic kidney disease.

Rajiv Sankaranarayanan, MBBS, FRCP (Lon), FESC, FHFA, PhD

Consultant Cardiologist and Heart Failure Lead

Liverpool University Hospitals NHS Foundation Trust

Liverpool Centre for Cardiovascular Science and NIHR Research Scholar and Honorary Senior Clinical Lecturer

University of Liverpool

Liverpool

UK

გაფრთხილება:

RS has research grants from the British Heart Foundation, the NIHR, NHSX (Transformation Agency), AstraZeneca, Biotronik, and the University of Liverpool. RS has received speaker fees/honoraria and travel reimbursement for conferences from AstraZeneca, Novartis, Vifor, Medtronic, Biotronik, Pfizer, Daaichi Sankyo, Roche, and Boehringer. RS has been appointed to: NHS England GIRFT Clinical Lead; NHS England HF Clinical Lead for Cheshire and Merseyside ICB; NHS England PIFU Pathway Committee for Heart Failure (2021); British Cardiovascular Society Vice President-Elect Digital, Communications and Media Committee; British Society for Heart Failure Board Councillor; Clinical Advisory Board of UK’s patient-led charity Pumping Marvellous (2020); and NHS England HF Expert Group.

Rachael Evans, MBChB, FRCP (UK), PhD

Associate Professor (Clinical)

University of Leicester

Honorary Consultant Respiratory Physician

Glenfield Hospital

Leicester

UK

გაფრთხილება:

RAE has given a lecture for a non-promotional industry-led session on long COVID by Moderna in 2023 and provided consultancy for a long COVID project for Astra Zeneca over the past 36 months totalling <£3000. RAE is the Chief Investigator for a long COVID study funded by Genentec Roche by a grant awarded to the University of Leicester.

Gerry Rayman, MD, FRCP

Consultant Physician and Head of Service

Diabetes and Endocrine Centre and the Diabetes Research Unit

Ipswich Hospitals NHS Trust

Ipswich

UK

გაფრთხილება:

GR received funding from Menarini in 2024 to attend the European Association for the Study of Diabetes conference. GR declares he received speaker fees from Abbott and consultancy fees from Eli Lily. GR undertakes several research projects on behalf of East Suffolk and North Essex NHS Foundation Trust for pharmaceutical companies which are on the NIHR portfolio (he does not receive payment himself for these).

Sotiris Posporelis, MD, MRCPsych

Consultant Liaison Neuropsychiatrist

King’s College Hospital

South London and Maudsley NHS Foundation Trust

Honorary Senior Clinical Lecturer

Institute of Psychiatry, Psychology & Neuroscience

King’s College London

London

UK

გაფრთხილება:

SP declares that he has no competing interests.

Asangaedem Akpan, MPH, FRCP

Consultant Geriatrician

Bunbury Regional Hospital

Western Australia Country Health Service

Bunbury

Western Australia

Visiting Professor

University of Cumbria

Carlisle

Honorary Clinical Associate Professor

University of Liverpool

Liverpool

UK

გაფრთხილება:

AA has a limited company that is seeking consultancy work offering reviews of healthcare services, facilitation of workshops, advice/review of publications.

Sanjay Agrawal, MBChB, FRCP

Consultant in Respiratory and Intensive Care Medicine

University Hospitals of Leicester NHS Trust

Leicester

UK

გაფრთხილება:

SA is a board member of Action for Smoking for Health (ASH), a healthcare charity related to tobacco control advocacy. SA is the National Specialty Advisor on Tobacco for NHS England and the Special Advisor for Tobacco for the Royal College of Physicians. SA undertakes research on the field of tobacco control but is not chief investigator for any studies at the time of making this declaration nor has he received any money or grants from pharmaceutical companies.

Acknowledgement: Martin Cowie

BMJ Best Practice would like to gratefully acknowledge Professor Martin Cowie for his previous role as expert adviser for the cardiovascular disease information in the Comorbidities Manager.

Martin Cowie MD, MSc, FRCP, FRCP (Ed), FESC, FHFA, FACC

Professor of Cardiology

Imperial College London (Royal Brompton Hospital)

London

UK

გაფრთხილება:

MC is chair of the European Society of Cardiology Digital Health Committee and a trustee of the Atrial Fibrillation Society. He has previously been a non-executive director of the National Institute for Health and Care Excellence. MC provides consultancy advice to AstraZeneca, Servier, Abbott, Medtronic, Boston Scientific, and Genomics PLC. MC declares that none of these interests is directly related to topics advised on for this project.

Acknowledgement: Andrew Lewington

BMJ Best Practice would like to gratefully acknowledge Dr Andrew Lewington for his previous role as expert adviser for the chronic kidney disease information in the Comorbidities Manager.

Andrew Lewington, BSc (Hons), MBBS, MEd, MD, FRCP

Consultant Renal Physician

Honorary Associate Professor

Nephrology Department

Leeds Teaching Hospitals NHS Trust

Head of MBChB

School of Medicine

University of Leeds

Leeds

UK

გაფრთხილება:

AL has been the principal applicant/co-applicant for a number of grants including: Engineering and Physical Sciences Research Council Research - multiplexed AKI biomarker detection with a single molecule biosensor; Leeds Cares - a novel, non-invasive diagnostic approach to assess kidney transplant health through the targeted measurement of biomarkers of kidney injury and immune response in kidney transplant recipients at the Leeds Teaching Hospitals NHS Trust; Kidney Research Yorkshire - use of enhanced technology to characterise haemodialysis treatment for acute kidney injury (AKI); Bringing It Home - validation of a micro-sampling technique for measuring tacrolimus and creatinine remotely, and to fund a research nurse; British Renal Society - renal function assessment with point of care creatinine in diverse populations (RAPID), and several NIHR grants including on a) Improving the quality of post-discharge care following AKI b) An investigation into the use of remote blood sample collection to reduce health inequalities in patients with mental health disorders c) A comparison of remote blood collection devices: a human factor use study d) Defining the characteristics for a novel automatic device to monitor urine output in catheterised patients e) Leeds Medtech and In-vitro Diagnostic Cooperative Grant Extension f) Surgical MedTech Co-operative for the 2019/20 proof-of-principle funding stream g) A pilot investigation into the use of beta-trace protein for residual renal function estimation in haemodialysis h) Application of functional MRI to improve assessment of chronic kidney disease (AFiRM study) i) SuperResPath-Renal: Quantitative super-resolution technology for a fast, decentralised clinical diagnosis of renal pathologies. AL is the co-author of several manuscripts including on extracorporeal treatments, AKI, kidney function testing prior to contrast-enhanced CT, plasma exchange and glucocorticoids in severe ANCA-associated vasculitis, COVID-19 rapid diagnostics, multimodal image-guided ablation on management of renal cancer in Von-Hippel-Lindau syndrome, and a summary of NICE guidance on CKD. AL is the author of several book chapters on nephrology and AKI. AL has received expenses for accommodation and travel for conferences at which he has given lectures, other than those delivered virtually. AL was a member of the AKI Scientific Program Committee for the ISN World Congress of Nephrology 2020-2021 and Chair of this same committee in 2021-2022.

რეცენზენტები: თანმხლები დაავადებები

Martyn Patel, BMBcH, FRCP, MA

Consultant, Older People's Medicine

Norfolk and Norwich University Hospitals

NHS Foundation Trust

Norwich

UK

გაფრთხილება:

MP is the NHS representative on the board for Norwich Institute for Healthy Ageing (unpaid role). MP participated in a podcast on the evolving nature and importance of comorbidities for BMJ Best Practice in October 2024. MP is submitting an application to the NIHR Research for Patient Benefit (RfPB) Grant Call on physical frailty, an Integrated Care Board (ICB) priority.

წყაროები

ჩვენი მტკიცებულებებისა და სარედაქციო ჯგუფები თანამშრომლობენ საერთაშორისო ექსპერტებსა და რეცენზენტებთან, რათა უზრუნველვყოთ თქვენი წვდომა კლინიკურად ყველაზე მნიშვნელოვან ინფორმაციაზე.

ძირითადი სტატიები

McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 Sep 21;42(36):3599-726.სრული ტექსტი  აბსტრაქტი

National Institute for Cardiovascular Outcomes Research; British Society For Heart Failure. National heart failure audit (NHFA) 2025 annual report (2023/24 data). 2025 [internet publication].სრული ტექსტი

National Confidential Enquiry into Patient Outcome and Death. Failure to function. 2018 [internet publication].სრული ტექსტი

National Institute for Health and Care Excellence. Acute heart failure: diagnosis and management. November 2021 [internet publication].სრული ტექსტი

გამოყენებული სტატიები

ამ თემაში მოხსენიებული წყაროების სრული სია ხელმისაწვდომია აქ.

ამ მასალის გამოყენება ექვემდებარება ჩვენს განცხადებას