Heart Failure: from diagnosis to treatment

Abstract

The Unified Health System (SUS) is one of the greatest achievements of Brazilian citizens, established following the National Health Conference of 1988. It is essential for quality of life in Brazil, excelling in the prevention and treatment of Chronic Heart Failure (CHF), a progressive condition that impairs the heart's ability to meet the body's metabolic demands. CHF affects about 23 million people worldwide and has a high in-hospital mortality rate in Brazil, approximately 12.6%. The disease can be silent initially due to the heart's compensatory mechanisms, which include activation of the sympathetic nervous system and the renin-angiotensin system. These systems attempt to maintain adequate blood flow but can lead to adverse effects over time, such as increased inflammatory cytokines and remodeling of the left ventricle. The main causes of CHF include diabetes, hypertension, ischemia, and Chagas disease. Treatment for CHF should integrate both pharmacological and non-pharmacological approaches, and adherence to therapy is crucial to reduce rehospitalizations. The socioeconomic impact of CHF is significant, with high costs for hospitalizations and medications, as well as productivity loss due to patients' incapacity. CHF can be classified by the severity of symptoms and the left ventricular ejection fraction, which may be preserved or reduced.