# 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**
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## 1. Diagnostic Hierarchy
### Suspected Heart Failure
- **Strongly Suspected Heart Failure**
- **Heart Failure Subcategories**
- **HFrEF**: [Empty]
- **HFmrEF**: [Empty]
- **HFpEF**: [Empty]
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## 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
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### Strongly Suspected Heart Failure
- **NT-proBNP > 125 pg/mL**
- **BNP > 35 pg/mL**
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### 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%
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## 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.