Snapshot A 60-year-old man presents to his primary care physician for several months of dyspnea on exertion, exercise intolerance, and lower-extremity swelling. He has a past medical history of sarcoidosis. On physical exam, he has jugular venous distension and pitting edema in the lower extremities. An echocardiogram shows an ejection fraction of 35%. Introduction Clinical definition login to view 17 more bullets Associated conditions login to view 2 more bullets Epidemiology Risk factors login to view 9 more bullets Etiology Pathogenesis login to view 13 more bullets Systolic dysfunction login to view 5 more bullets Diastolic dysfunction login to view 7 more bullets High-output heart failure login to view 4 more bullets Presentation Symptoms login to view 5 more bullets Physical exam login to view 12 more bullets Imaging Chest radiograph login to view 6 more bullets Echocardiogram login to view 6 more bullets Studies Atrial and B-type (brain) natriuretic peptide (ANP and BNP) login to view 3 more bullets Electrocardiogram (ECG) login to view 4 more bullets Making the diagnosis login to view 1 more bullet New York Heart Association Functional Classification of Heart FailureClassLimitations of Physical ActivityHeart Failure SymptomsINoneNo symptomsIIMildSymptoms with significant exertion; comfortable at rest or mild activityIIIMarked limitationSymptoms with mild exertion; only comfortable at restIVConfined to bed or chairSymptoms occur at rest Differential Acute respiratory distress syndrome login to view 3 more bullets Treatment Management approach login to view 4 more bullets Conservative login to view 3 more bullets Medical login to view 44 more bullets Medical devices login to view 8 more bullets Complications CHF exacerbation Cardiac arrhythmias Respiratory failure