Topic overview

Start with the big picture

HF is classified by ejection fraction as HFrEF (≤40%), HFmrEF (41–49%), or HFpEF (≥50%). NYHA classes I–IV describe how symptoms limit activity, with higher classes indicating greater severity. Common findings include dyspnea, orthopnea, edema, rales, elevated jugular venous pressure, and an S3. Evaluation may include natriuretic peptides, echocardiography, ECG, chest radiography, and laboratory testing. For HFrEF, the core medication pillars are renin–angiotensin system therapy (including ARNI when appropriate), evidence-based beta-blockers, mineralocorticoid receptor antagonists, and SGLT2 inhibitors. Diuretics help manage congestion, while additional options and non-pharmacologic measures are considered according to the clinical picture. Monitoring and follow-up are central to ongoing care.