A syndrome, not a single disease — and why “heart failure” should point you to phenotype, cause, severity, and current state, not just a label.
Heart failure is a clinical syndrome: an abnormality of cardiac structure or function that causes symptoms and/or signs of congestion or low output, supported when needed by objective evidence such as imaging, biomarkers, or hemodynamics. Common causes include ischemic heart disease, hypertension, valvular disease, cardiomyopathies, arrhythmias, and toxic/metabolic, inflammatory, or congenital causes.
EF phenotype (2026 update)
The 2026 ESC update simplified symptomatic HF into two phenotypes: HFrEF (LVEF < 50%) and HFpEF (LVEF ≥ 50%), removing HFmrEF as a separate category. The 2026 Second Universal Definition emphasises reduced / preserved / improved EF categories without imposing one universal numeric cut-off, because EF varies with the patient and how it is measured. So name the framework rather than presenting one number as absolute (older resources use ≤40%, 41–49%, ≥50%).
Clinical connection
Two patients can carry the same HF diagnosis: one stable with exertional fatigue, the other acutely decompensated with severe dyspnea, pulmonary edema, and hypoxemia. Their nursing priorities are completely different — so establish the current state before anything else.
Nursing role
Always establish: stable or decompensated? Congested or not? Adequate perfusion or hypoperfusion? And is there a trigger — infection, ischemia, arrhythmia, uncontrolled BP, medication nonadherence, or excess sodium/volume?
Check answer
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