Heart failure (Part 1)

Heart failure (HF) is a clinical syndrome comprising symptoms and signs. From a pathophysiological viewpoint, the old concept of a hemodynamic disorder has given way to a newer neurohormonal model, which underlines the deleterious role of activation of the Renin-Angiotensin-Aldosterone System (RAAS) and excessive sympathetic tone. A distinction is made between HF with predominantly systolic dysfunction (suboptimal emptying of the left ventricle [LV]), and HF with predominantly diastolic dysfunction (suboptimal filling of the LV). In the geriatric population, the prevalence of diastolic dysfunction is high. However, it is not uncommon to observe both systolic and diastolic dysfunction in the same patient. Echocardiography is the imaging technique of choice to identify the causes of HF in the elderly patient.