Insuficiencia cardíaca: epidemiología, mecanismos etiopatogénicos y clasificación

Abstract

Heart failure (HF) is a syndrome characterized by the presence of signs and symptoms of systemic/pulmonary congestion and/or low output. Its prevalence is increasing and it has a high mortality rate. It may be due to multiple cardiac and some extracardiac conditions. The key elements for diagnosis are the medical history, physical examination, natriuretic peptides determination, and echocardiogram. Knowing the left ventricular ejection fraction is essential, since it defines groups with different etiopathogenesis, management, and prognosis. Activation and maintenance of the neurohormonal axis is the main trigger for disease progression in HF. In addition, there is ventricular remodeling as an adaptation to volume or pressure overload, either by heart chamber dilation or by ventricular hypertrophy. Treatment aimed at the cause and neurohormonal axis blockade is key to management and has prognostic implications in patients with HF with reduced ejection fraction.