Heart failure in real life

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Heart failure in real life

Michael Marber, FRCP, FACC, PhDMichael Marber, FRCP, FACC, PhD
BHF Center of Research Excellence, Cardiovascular Division, The Rayne Institute, St Thomas’ Hospital, London, United Kingdom

  • This issue of Heart and Metabolism is dedicated to heart failure in the real world and highlights the everyday problems faced in the identification of this syndrome and in its effective management. These issues are complex, so when the manuscripts arrived, I was amazed at their clarity. A good place to start is at the beginning: How do we diagnose heart failure?
    Dr Cowie provides a comprehensive overview of the assessment of the breathless patient, offering
    a mixture of guideline pragmatism and personal opinion. The article is divided by mode of presentation—
    chronic breathlessness in the community/primary care setting versus acute breathlessness in the emergency room. Assessment in the community is particularly difficult due to the nonspecific nature of heart failure symptoms of breathlessness, fatigue, and ankle edema. Although a careful history and clinical examination are important, it is sobering how the use of B-type natriuretic peptide (BNP) dominates the guidelines; I think this probably reflects the difficulty in standardizing the clinical assesment of heart failure rather than indicating the infallibility of BNP. (…)
    Read the full editorial

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