Heart failure
Diagnosis by ejection fraction category, the four pillars for HFrEF, devices, HFpEF, and managing acute decompensation.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Heart failure is a clinical syndrome of symptoms (breathlessness, fatigue, swelling) and signs caused by a structural or functional cardiac abnormality, confirmed by raised natriuretic peptides or objective evidence of congestion.
- Classify by LVEF because treatment depends on it. ESC 2026 uses two groups, split at 50%. HFrEF has the strongest evidence base.
- In HFrEF, start all four pillars early and titrate fast: ARNI or ACE inhibitor (ARB if neither is tolerated), beta-blocker, MRA and SGLT2 inhibitor.
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Sources
- National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand Guidelines for the prevention, detection, and management of heart failure in Australia 2018AU/NZNational Heart Foundation of Australia and CSANZ (Heart, Lung and Circulation), 2018
- Køber L, Adamo M et al. 2026 ESC Guidelines for the management of heart failure. Eur Heart J 2026. doi:10.1093/eurheartj/ehag100European Society of Cardiology, 2026
- 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure, and 2023 focused update (superseded; source of the HFmrEF category)European Society of Cardiology, 2021, updated 2023
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy