Cohort Definition Name: “Left Heart Failure”
Contributor name: Joel N. Swerdel
Contributor OrcId: 0000-0001-9491-2737
Logic Description: First occurrence of Left Heart Failure.
Recommended study application: outcome, indication
Assertion statement: This cohort definition was executed on at least one real person-level observational health data source and resulted in a cohort with at least 1 person.
Submitted cohort definition:
lhf.txt (10.6 KB)
Target Clinical Description
Left heart failure, also known as congestive heart failure (CHF), is a condition characterized by the impaired ability of the left side of the heart to pump blood effectively. It occurs when the left ventricle becomes weakened or stiff, leading to a decrease in the heart’s ability to supply oxygenated blood to the body. Left heart failure can result from underlying conditions such as coronary artery disease, hypertension, or valvular heart disease. Common symptoms include shortness of breath, fatigue, fluid retention (edema), coughing, and reduced exercise tolerance. Left heart failure requires medical management to relieve symptoms, improve heart function, and prevent complications.
Presentation for left heart failure:
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Shortness of breath, especially during physical activity or while lying flat (orthopnea)
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Fatigue and weakness
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Persistent cough, often accompanied by white or pink-tinged frothy sputum
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Rapid or irregular heartbeat (arrhythmias)
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Fluid retention, leading to swollen ankles, legs, and abdomen (edema)
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Reduced exercise tolerance and inability to perform usual activities
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Sudden weight gain or loss
Assessment for left heart failure:
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Detailed medical history, including symptoms, risk factors, and previous cardiac events
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Physical examination to assess signs of fluid retention, abnormal heart sounds, and respiratory distress
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Diagnostic tests, such as echocardiography, electrocardiogram (ECG), chest X-ray, and blood tests (e.g., BNP levels) to evaluate heart function, identify underlying causes, and assess the severity of left heart failure
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Assessment of functional limitations and exercise capacity through exercise stress tests or other appropriate methods
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Evaluation of comorbid conditions, such as hypertension or coronary artery disease, which can impact left heart failure management
Differential diagnoses for left heart failure:
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Chronic obstructive pulmonary disease (COPD): Respiratory conditions like COPD can cause symptoms similar to left heart failure, such as shortness of breath and coughing.
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Pulmonary hypertension: Increased blood pressure in the pulmonary arteries can lead to symptoms overlapping with left heart failure.
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Asthma: Asthma can cause wheezing and shortness of breath, which may mimic left heart failure symptoms.
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Other forms of heart failure: Right heart failure, which can coexist with left heart failure, may present with similar symptoms.
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Other cardiomyopathies: Conditions such as dilated cardiomyopathy or hypertrophic cardiomyopathy may cause symptoms resembling left heart failure.
Treatment plan for left heart failure:
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Medications: Prescribing medications such as diuretics, angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, and aldosterone antagonists to manage symptoms, improve heart function, and control blood pressure.
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Dietary modifications: Recommending a low-sodium diet to reduce fluid retention and minimize symptoms of edema.
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Fluid management: Monitoring fluid intake and adjusting diuretic therapy as needed to maintain fluid balance.
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Regular physical activity: Encouraging supervised exercise programs or tailored physical activity to improve cardiovascular fitness and overall well-being.
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Cardiac rehabilitation: Referring patients to a cardiac rehabilitation program to provide structured exercise training, education on heart-healthy habits, and emotional support.
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Monitoring and follow-up: Regular assessment of symptoms, medication management, and monitoring of cardiac function through periodic tests, such as echocardiography and blood work.
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Invasive interventions: In some cases, individuals with severe left heart failure may require interventions such as coronary revascularization, valve repair or replacement, or implantation of a cardiac resynchronization therapy (CRT) device.
Prognosis for left heart failure: The prognosis for left heart failure varies depending on several factors, including the underlying cause, the severity of the condition, the individual’s response to treatment, and the presence of comorbidities. With appropriate management, lifestyle modifications, and adherence to treatment plans, the prognosis can be improved. However, left heart failure is a chronic condition that requires ongoing care and monitoring. Close collaboration with healthcare professionals, diligent self-care, and adherence to medication and lifestyle recommendations are crucial for optimizing prognosis and maintaining a good quality of life.