# Technical Document Analysis: Heart Failure Diagnostic Criteria ## Document Structure The image contains structured medical knowledge and diagnostic criteria for heart failure, organized into two primary sections: 1. **Diagnostic Hierarchy** 2. **Clinical Knowledge Base** --- ## 1. Diagnostic Hierarchy ### Suspected Heart Failure - **Strongly Suspected Heart Failure** - **Heart Failure Subcategories** - **HFrEF**: [Empty] - **HFmrEF**: [Empty] - **HFpEF**: [Empty] --- ## 2. Clinical Knowledge Base ### Suspected Heart Failure #### Risk Factors - CAD (Coronary Artery Disease) - Hypertension - Valve disease - Arrhythmias - CMPs (Cardiomyopathies) - Congenital heart disease - Infective - Drug-induced - Infiltrative - Storage disorders - Endomyocardial disease - Pericardial disease - Metabolic - Neuromuscular disease #### Symptoms - Breathlessness - Orthopnoea - Paroxysmal nocturnal dyspnoea - Reduced exercise tolerance - Fatigue - Tiredness - Increased time to recover after exercise - Ankle swelling - Nocturnal cough - Wheezing - Bloated feeling - Loss of appetite - Confusion (especially in the elderly) - Depression - Palpitation - Dizziness - Syncope #### Signs - Elevated jugular venous pressure - Hepatojugular reflux - Third heart sound (gallop rhythm) - Laterally displaced apical impulse - Weight gain (>2 kg/week) - Weight loss (in advanced HF) - Tissue wasting (cachexia) - Cardiac murmur - Peripheral edema (ankle, sacral, scrotal) - Pulmonary crepitations - Pleural effusion - Tachycardia - Irregular pulse - Tachypnoea - Cheyne-Stokes respiration - Hepatomegaly - Ascites - Cold extremities - Oliguria - Narrow pulse pressure --- ### Strongly Suspected Heart Failure - **NT-proBNP > 125 pg/mL** - **BNP > 35 pg/mL** --- ### Heart Failure Classification - **Abnormal findings from echocardiography** - **LA volume index > 34 mL/m²** - **E/e ratio at rest > 9** - **PA systolic pressure > 35 mmHg** - **TR velocity at rest > 2.8 m/s** - **Relative wall thickness > 0.42** #### EF (Ejection Fraction) Categories - **HFrEF**: LVEF < 40% - **HFmrEF**: LVEF 41-49% - **HFpEF**: LVEF > 50% --- ## Notes - No charts, diagrams, or data tables present in the image. - All information is textual and structured hierarchically. - Medical terminology follows standard cardiology nomenclature. - No non-English content detected.