2 Indications and current treatments

2 Indications and current treatments

2.1 Heart failure is a complex clinical syndrome of symptoms that occur when the efficiency of the heart as a pump is impaired. It leads to reduced blood flow to the body tissues and increased filling pressure in the heart, which causes congestion and oedema in the lungs (causing breathlessness) or the body (causing swelling of the legs). Other symptoms include reduced exercise tolerance, fatigue and malaise.

2.2 Medical treatment of heart failure involves drugs such as diuretics and inotropic agents. Invasive therapies include electrophysiological interventions such as pacemakers and implantable cardioverter defibrillators, revascularisation by percutaneous coronary angioplasty and stenting or coronary artery bypass grafting, valve replacement or repair, and temporary use of intra‑aortic balloon pumps. In chronic heart failure, conventional treatment strategies may no longer work, resulting in the need for heart transplantation. Ventricular assist devices can be used to provide temporary circulatory support while a patient awaits heart transplantation (bridge‑to‑transplantation).

  • National Institute for Health and Care Excellence (NICE)