from Medical topics
Published online by Cambridge University Press: 18 December 2014
Heart failure
Heart failure is a complex syndrome that can result from any structural or functional cardiac disorder which impairs the ability of the heart to pump (Cowie & Zaphiriou, 2002). Impairment in the pumping action of the heart can lead to a build-up of fluid in the lungs and extremities, causing symptoms of breathlessness and fatigue and signs of fluid retention in pulmonary congestion and peripheral oedema. It is primarily a disease of the elderly with an average age at diagnosis of 76 years and is more common in men than women. Heart failure is a major public health problem having an estimated prevalence of 0.4–2% in the general European population (Cowie et al., 1997). Recurrent prolonged hospital admissions are common and mortality is high. In the Framingham Heart Study, among a cohort with onset of heart failure between 1990–1999, one-year mortality was 28% in men and 24% in women; five-year mortality was 59% and 45% respectively (Levy et al., 2002).
Quality of life and mood
People with heart failure have reported poorer quality of life than that of the general population and those with a range of other chronic illnesses (Hobbs et al., 2002) (see ‘Quality of life’). The extent to which their quality of life is impaired appears to be related to the extent of functional impairment as measured by the New York Heart Association classification (NYHA). Impairment in quality of life has been found to be related to both morbidity and mortality.
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