Hello and welcome to the zero to finals podcast.

My name is Tom and in this episode I'm going to be talking to you about chronic heart failure.

And you can find written notes on this topic at zero to finals.com slash heart failure

or in the cardiology section of the zero to finals medicine book.

So let's get straight into it.

Chronic heart failure refers to the clinical features of impaired heart function,

specifically the function of the left ventricle to pump blood out of the heart and around the body.

Impaired left ventricular function results in a chronic backlog of blood waiting to flow into and through the left side of the heart.

The left atrium, pulmonary veins and lungs experience an increased volume and pressure of blood which is built up waiting to enter

and go through the left side of the heart. They start to leak fluid and cannot absorb

excess fluid from the surrounding tissues and this results in pulmonary edema or fluid

building up in the lungs.

The ejection fraction is the percentage of blood in the left ventricle that's squeezed out with

each ventricular contraction. An ejection fraction above 50% is considered normal.

Heart failure with reduced ejection fraction is when the ejection fraction is less than

50%.

Heart failure with preserved ejection fraction is when someone has the clinical features of heart

failure but the ejection fraction remains above 50%.

This is the result of diastolic dysfunction,

where there's an issue with the left ventricle filling with blood

during diastole when the ventricle is supposed to be relaxing and filling.

The top five causes for chronic heart failure are ischemic heart disease,

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