…state of inadequate tissue and end organ perfusion caused by cardiac insufficiency. Sustained hypoperfusion reduces oxygen and nutrient delivery and, when severe or prolonged, produces…

…and reduction of cardiac fibrosis through activation of the natriuretic peptide A receptor. NT proBNP is an inactive cleavage product and has no direct biologic…

…Symptoms related to fluid retention and worsening congestion The clinical course may be chronic and relatively stable or punctuated by episodes of worsening heart failure…

…even in the absence of pulmonary congestion. Patients may obtain relief by sitting forward. Other symptoms depend on the extent of reduction in cardiac output…

…Assessment should integrate the history, physical examination, laboratory data and diagnostic testing. Examination for congestion Useful bedside indicators of persistent or improving congestion include: J

…stress generally indicates previous infarction. Extensive ischaemia may produce a reduction in global LVEF and transient LV cavity dilatation during stress. Stress echocardiography can also…

…Use of cannabis, electronic cigarettes or other inhaled products. Readiness to attempt cessation. Depression, schizophrenia, schizoaffective disorder, HIV infection or other circumstances that may affect…

…cardiovascular risk reported a 30% reduction in major cardiovascular events with a Mediterranean diet supplemented with either nuts or extra virgin olive oil compared with…

…that of statins. Statins reduce hepatic cholesterol synthesis, whereas ezetimibe limits intestinal cholesterol uptake. Expected LDL C reduction Ezetimibe produces a modest LDL C reduction…

…was related to the magnitude of heart rate reduction. Ivabradine is also a reasonable consideration when a beta blocker cannot be tolerated or is contraindicated…