Fast Five Quiz: Heart Failure Comorbidities

Ioana Dumitru, MD; Jeffrey J. Hsu, MD


December 09, 2022

Figure 1. Swelling of the lower extremities is caused by edema, which is an abnormal accumulation of fluid in the body tissues. The edema in this case is secondary to heart failure.

Cognitive impairment is common among patients with HF, with many patients demonstrating reduced cognition across multiple cognitive domains. The degree of cognitive impairment may be related to the severity of HF. Cognitive dysfunction can present in patients with HF across the spectrum of disease, from mild cognitive impairment to vascular dementia and Alzheimer's disease. Some form of cognitive dysfunction is observed in approximately 40%-60% of all patients with chronic HF, which is associated with poorer functional performance, self-care and treatment adherence, more frequent hospitalizations, and a poor prognosis.

During episodes of left heart decompensation and fluid overload, characteristic lung function test findings, reduced FVC, and reduced FEV1 may make interpretation of lung function tests difficult. Ideally, spirometry should be performed in compensated patients after optimal diuretic therapy to avoid misdiagnosis.

In many patients with chronic HF, sleep-disordered breathing cannot be easily diagnosed on the basis of questionnaires designed to screen for daytime somnolence, as many of the symptoms overlap with symptoms of HF. The gold-standard test for diagnosing sleep-disordered breathing is polysomnography, or the overnight sleep study. Screening with overnight pulse oximetry and home polygraphy may also identify patient with HF and sleep-disordered breathing.

In individuals without HF, ferritin levels are proportionally related to the amount of iron stores in the body. However, ferritin levels increase with concomitant acute or chronic inflammation, such as chronic HF. International guidelines on HF define iron deficiency as a serum ferritin level <100 ng/mL, or a serum ferritin level of 100-299 ng/mL with a transferrin saturation <20%.

Learn more about HF.


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