Cardiomark - questionnaire for suspected heart failure

Questionnaire for suspected heart failure - please complete available details

Please complete the questionnaire below relating to a patient with suspected heart failure. 

Sex



Check if the following is available




Past medical history - check if applies











Clinical examination - check if applies












What is heart failure?

Heart failure is a clinical syndrome caused by a variety of cardiovascular diseases where the heart does not pump blood around the body as well as it should.  It can arise due to structural abnormalities or functional abnormalities of the heart, which impair the ability of the ventricles to fill with or pump out blood. 

This means that the blood can't deliver enough oxygen and nourishment to the body to allow it to work normally. This, usually causes tired or fatigue and means that the body can't eliminate waste products properly - leading to a build up of fluid in the lungs and other parts of your body, such as your legs and abdomen.

Heart failure can develop at any age but clearly becomes more common with increasing age. Around 1% of people under 65 years of age have heart failure, but 7% of 75-84 year olds have heart failure and this increases to 15% in people older than 85. It often develops following coronary artery disease, a myocardial infarction or hypertension. Other common causes are arrhythmia and valve disease. It is the most common cause of hospitalization in patients over 65 years of age. A general practitioner in Ireland with 2,000 patients could expect to have 40-50 patients with heart failure, fifteen suspected new cases each year with five confirmed new cases each year.

The underlying cause of heart failure should be determined where possible as the treatment of the underlying cause is important. There are two major categories of heart failure

  1. due to difficulty with pumping blood out of the heart (heart failure with left ventricular systolic dysfunction) 
  2. when the ability of the heart to pump blood is normal but its ability to fill the ventricles with blood is impaired.  This is known as heart failure with preserved ejection fraction (also known as heart failure with preserved systolic function or diastolic heart failure). 

Click here for more information about heart failure

What are the diagnostic criteria for heart failure?

For heart failure to be diagnosed the following three criteria must be met (European Society of Cardiology):

Heart failure is a clinical syndrome in which patients have the following features:

 

Symptoms typical of heart failure

 (dyspnoea, fatigue, peripheral oedema)

AND

Signs typical of heart failure

(tachycardia, tachypnoea, pulmonary rales, pleural effusion, raised JVP, peripheral oedema , hepatomegaly)

AND

Objective evidence of a structural or functional abnormality of the heart at rest

(abnormality on echocardiogram, cardiomegaly, S3, raised natriuretic peptide level)

Some patients may have evidence of structural or functional abnormality of the heart on echocardiogram but no symptoms or signs of heart failure.  These patients do not have heart failure (See section on asymptomatic LVD)